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BP-A295.052

APRIL 1994

# SPECIAL HOUSING UNIT REVIEW

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

Inmate Name:

EPSTEIN, JEFFREY EDWARD

Register Number:
76318-054

Unit

5

Institution:

NEW YORK MCC

Date Entered Special Housing:
07-29-2019

Reason for Placement:

PENDING DHO FOR CODE 228 SELF-MUTILATION

1. Subject: (2 or 3 Days)

Date Reviewed

08-01-2019

3 Day Review

Action Taken on the Above Date:

Continue in Special Housing Unit

Printed Name/Signature:

II. RECORD REVIEW (To be done weekly in the inmate's absence, beginning after the in-person 7 day review, and continuing every week between each in-person 30 day review.)

<table><tr><th>DATE</th><th>ACTION TAKEN</th><th>REMARKS</th><th>SIGNATURE</th></tr><tr><td>08-05-2019</td><td>Continue in Special Housing Unit</td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr></table>

III. Subject: (7 or 30 Days)

Review By (SRO):

Reviewing Authority:

7 Day Review

Date inmate appeared for a Special Housing Review:
08-05-2019

Or Date inmate waived right to appear:

01-01-111

Has been seen daily by Medical Staff. ✓ Yes; No

Has been seen daily by responsible officer designated by Warden:

# SPECIAL HOUSING UNIT REVIEW (cont.)

Yes:  No

Has received prescribed weekly exercise: ✓ Yes;  No

Proper documentation and justification in the Central File (Incident Report, DHO Report, copies of Special Housing Review Form): ✓ Yes; No if no, why not?

✓ Yes;  No

Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housing status?

Is there an additional assessment for every one month interval thereafter? ✓ Yes; No if no, why not?

Action taken on the above date by the Segregation Review Official or the Reviewing Authority:

Released from Special Housing; ✓ Continue in Special Housing

Did inmate in Administrative Detention receive a written copy of staff's 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)?

Remarks: (Any 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 form):

Date of Next Review:

08-12-2019

Printed Name and Signature of Segregation Review Official or the Reviewing Authority and Date Signed:

Record Copy-Central File This form replaces BP-295(52) dated January 1988

# SPECIAL HOUSING UNIT REVIEW (cont.)

file:///C:/temp/shu/Epstein-Reno76318-054_SRO_20190729-20190810.html

8/13/2019

EFTA00037698