EFTA00140484.pdf

Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: ONLY ITEMS ALLOWED: Lp 5 -c Register #: li4 9°Ol l- G54 Suicide Mattress Institution: E CU as 2 "O :O Date Watch Began / Ended eri 9-) V) V) V) To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - INMATE EFTA00140484 STAPLE LOCAL PROCEDURES HERE Check one of the following: h. 0 This is the initial log book for this suicide watc Enter date and time watch began: 0 This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: minutes. Document your observations every of your shift. Legibly print and sign your name at the beginning EFTA00140485  Suicide Watch Observation Log Name of inmate — on watch: 1„ „._ 4JY -it i ( 1 Reg Si: 143 10• 054 Date: - 1 23e Time Observations: Briefly note your observations. Initial all entries. Initials j :LjO M Sr e‘1514 ,tudv) -JO S IA it i &E cell #14 o — l ' LIS" ,A% ii Oki ge-a ---O--L A, 2.--i i fr ife.i. .— 2. a int'l 2 % 0., II .5 fr. , me ( ( k ei • J i.6 tel( f' 2 5 t's 01 S cehii wi (0? ...3 -fill iw y h (-Cu—44 S. a Afpr 2' 434 t f NC a it -I ov g F 43 I 0 Avi Cr Y1 u. 6e 13 -'5---- 3.9 'c604, 4-4 kw!). fie Iti fd Ci El A 6( 0 3 sts g tii F-e3 Lk.r A., 7d-e 4._..tm. :F.- W' S-b-p..all 44— .&A rlt - -1f--( -14,1 I eihp tow S 4 A.At L.5 -Atte 0 — O Ce f r grim- w C i ,k, k4 .. g r itty' m >\1-1k _ A" IAA Note to all observers: Legibly print gnd sign your name at the beginning of your shift. 1 EFTA00140486  Suicide Watch Chronological Log Staff Suicide Watch Observers Only Name of inmate on watch: Ep54-e".4"). J. Register #: 1. Co Sta- ma y Institution: MOT', New \leo< Date Watch Began / Ended July 23,2014 J-v)/ iq To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - STAFF EFTA00140487 STAPLE LOCAL PROCEDURES HERE Check one of the following: This is the initial log book for this suicide watch. Enter date and time watch began: July 23)20in a+ ( .MOAN This a continuation log book for this watch. . . „ Eriter date and time this watch book was Instructions to Observer: Document your observations every )5 minutes. Legibly print and sign your name at the beginning of your shift. EFTA00140488  Ep,54e_in Suicide Watch Observation Log Name., of inmate on watch: Reg #: -q(13 lb- (-1524 Date: ' 23 Ici Time Observations: Briefly note your observations. Initial all entries, Initials I ..-40 Am 1nmck bvot hi- riwin fo Su ir ide Cel I -WI- l '. zi5Akq1 inrndfe 1\lio on bed j et 2,0DAm Inmoi-e , i-i-finr1 On bed +0 lki09 2 . 1.5A ,/i inrn-feOicti-eolli 5 CeIII11C11-e. -ked, -I-o Mika) 2'.30Am tnrrOk 3i-\-iins on bad .41icnio remember vvh-11- happened, 2. .i54,4 Inmafe 6i-i-l-ir9 on Led 3..apayi InmcAt_ 6 HA; o bed ai5A0 <&...5 piefures a i rynl-42. 5.30Am Inrmi-e. oi+-iir3 on be(' r 5',45Am Inmafe 6i-ftin3 on bed 42. ()DAM In cro+e, L54-ting on bed 4', 15Ani I nino4-e Lli4-1-in5 Dr) bed 4...30Am nern-i-e. ,5}nroin3 co- door -fakir-9 4-45Am Inc/Yale. c_540rrlin9 04- door -1-allcie-9 5*.COArvi Inrno+e 6 i++Ms on ixd 5:15Am i nrnak Olardi a+ door 5'.,3c)Awi Inmak 6-11-Indi no 04 door .. 5',45ANI Iniena-le cSkinriing c# door (x)..DOPktvi Intna-te —1-lartlino al- cictr Co'. I5Am Int-ne. c,54ni liro 04- door 41?:,3oAt,4 In +e (_54anOiro cl+ doof (0'.45Am Incralt., Olan6ins Cli- (k)nr 4'.00,00.4 inmcil-e- ,NOnain9 a4- Ow' Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140489