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: 5UNT MGR.
Cell: 5

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

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

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

Special Housing Unit Cell Number: H01-001L
Inmate Is In: DS AD
AD Status: <empty>
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>07-21-2019</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></td><td></td><td></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>Y</td><td>No</td><td>01:00</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></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><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></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>

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 al 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)

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Prescribed by P5270

This tom replaces BP•292(52) dated AUG 2011.

EFTA00036901