EFTA00036572.pdf

Page 1 of 1 BP -A295.052 SPECIAL HOUSING UNIT REVIEW APRIL 1994 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS wave Name EPSTEIN, JEFFREY EDWARD Date Entered Special Housing: 07-10-2019 Register Number 76318-054 Unit 5 Reason for Placement PENDING CAPTIANS REVIEW Institution NEW YORK MCC 1. Subject: (2 or 3 Days) 3 Day Review Date Reviewed 07-15-2019 Action Taken on the Above Date: Continue in Special Housing Unit Printed Name/Signature: II. RECORD REVIEW. (To to done weekly in the inmates absence, beginning after the in-person 7 day review, and cord nuing every week between each in-person 30 day review.) DATE ACTION TAKEN REMARKS SIGNATURE 07-19-2019 Continue in Special Housing Unit III. Subject (7 or 30 Days) 7 Day Review Review By (SRO): Reviewing Authority: Date inmate appeared for a Speoal Housing Review: 07.19.2019 Or Date inmate waived right to appear 01-01-111 Has been seen daily by Medical Staff Yes: El No Has been seen daily by responsible officer designated by Warden- Has received prescribed weekly exercise: RI Yes: ICI No Proper documentation and jusecation In the Central File (Incident Report. OHO Report copies of Special Housing Review Form): g Yes; q No if no, why not? Yes; ❑No Is there a written psychiatric a psychologal assessment on the inmate who has spent 30 days in a special housing status? g yes; D No Is there an additional assessment for every one month interval thereafter? 47‘1 Yet CI No if no, why not? Action taken on the above date by the Segregation Review Official or the Reviewing Authority: q Released from Special Housng; WI Continue in Special Hoeing Did inmate In Administrative Deletion receive a written copy of Staffs decision and the basis for the finding at each 30 day review? Yes; q No if no, why not (Should be given provided institutional security not compromised)? Remarks: (My 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 07-26-2019 PrEntPa Marne' and Sin nature of Segregation Review Official or the Reviewing Authority and Date Signed: Record Copy Central Fie This form replaces BP -295(52) dated January 1988 file:///C:/temp/shu/Epstein-Reno76318-054_SRO_20190710-20190723.html 8/13/2019 EFTA00036572