BP-A0292

APR 16

# SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

NEW YORK MCC
(Institution)

Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No.: 76318-054

Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: A&O <empty> UNIT MANAGER <empty> Cell: A&O

Violation or Reason: PENDING CLASSIFICATION
Date Rec'd: 2019-07-07
Time Rec'd: 19:20

Admittance Authorized: <empty>
Date Rel.: <empty>
Time Rel.: <empty>

Pertinent Information: N/A
Separation Information: N/A

Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: DS AD AD Status
Is Inmate on Medication: N
Medical Department Notified: Y

<table><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><td>B</td><td>D</td><td>S</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></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</td><td>Y</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></table>

07-11-2019:
Morn: Y
Day: Y N Ref See 2nd page
Eve: Y

07-12-2019:
Morn: Y
Day: Y See 2nd page
Eve: Y

07-13-2019:
Morn: Y
Day: Y
Eve: Y

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) Visit. (M) Medical. (C) Court, (O) Other - Yes (Y) if applicable / Enter Actual Time Period Stan and End (i.e., 0930 -1030 hrs) in OW 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 tom replaces BP•292(52) dated AUG 2011.

EFTA00036904

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

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

EFTA00036905