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 X <empty> Cell: A&O

Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-10
Time: 15:26
Rec'd: <empty>
Rec'd: <empty>

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>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></tr><tr><td>07-14-2019</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></tr><tr><td>07-14-2019</td><td>Eve</td><td></td><td></td><td>[x] Y</td><td>N</td><td>No</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></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></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></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></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>See 2nd page</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></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></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></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></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></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>See 2nd page</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></tr><tr><td>07-19-2019</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>07-19-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td></td><td>00:15</td><td>See 2nd page</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></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></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></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></tr></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 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 (is., 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.

EFTA00036585

|            | Day shift comments:                   |
|-|-|
| 07-15-2019 | Health: Voices no medical complaints. |
|            | Day shin comments:                    |
| 07-16-2019 | Health: Voices no medical complaints. |
|            | Day shift comments:                   |
| 07-17-2019 | Health: Voices no medical complaints. |
|            | Day shift comments:                   |
| 07-18-2019 | Health: Voices no medical complaints  |
|            | Day shin comments:                    |
| 07.19.2019 | Health: Voices no medical complaints. |

EFTA00036586