EFTA00120189.pdf

Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: er3 :Le'YN ONLY ITEMS ALLOWED: In C a MO Register #: ▪ al CO Suicide Mattress c-51 4/1 ch u Institution: O W E • cL) fa av Date Watch Began / Ended 'z5 n (241 oita v) To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - INMATE EFTA00120189 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: ❑ This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. EFTA00120190  Suicide Watch Observation Log Name of Inmate arytecn on watch: Reg #: 145(13 O514 /1 Date: —1 25 i lq Time Observations: Briefly note your observations. Initial all entries. Initials 1:14°Alv IM &cot Ok+ a6t4.4n •;G StA &G IT r cc) f I 11-4 , --- 1 -ICkivi 'IA Irti Is e\ on! g eo .---- _0 2 (Alm ki w /AI i 1 Af t e--) i k ( fe --__. . "--' 2"%twi 1 tm I-A kJ ,S r-e(1.14-k ) rilel 4 Iciu 2 5 brim ‘I 4.41 SSIrh 4 44 (01i 4i-t,1 047 h rttimea.C-4/ tA A 4- tiAer i/l ...------ 2 2 i- 4 544, ( ktA Sr P.).4 one 3 t i3 5.'0,0 t o, C II 61" 6eb ...„— 99---- 3. f c,-„,, 4-4 k4 pi( {art ?Av. 4 is Si kl ,. Pic o ------ eh 4 a, ge..3 Tr\ IA, S Al. VI Or' 'Rt 1 Lk) .f 1 C >:, -114 Q\ „ , 16 ..._ ".. 1 13-Th '.5() 1 inn VA-it/V , -3-dr 1 44 - beer ‘- 1-14-- kill co :45 - . to ni-st —I,Atok --Ad ego, 31-1-4,kiti --I tr w 17 Siktil i 0 --" 1 ) 3 1-5;^ \ Al —Y1-A--f`-. kir° 4-1fr brei c_. tc"414, (m c4irx k j II' ' (4+ 6 cov- Sttrot k/Ai --h-k-\ w Ad-- Nc4' 2 -- (9 (fr kW k f0.4 cl4-14,di ti 44 Ar, Note to all observers: Legibly print and sign your name at the beginning of your shift. 1 EFTA00120191  Suicide Watch Chronological Log Staff Suicide Watch Observers Only Name of inmate on watch: Ept4e- in „ Register #: 1(03iF1)-054 Institution: Mer. Nr.wAcyK Date Watch Began / Ended July 23,2-014 *I, To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - STAFF EFTA00120192 STAPLE LOCAL PROCEDURES HERE Check one of the following: V This is the initial log book for this suicide watch. Enter date and time watch began: July 2312olci at 1.4oAM 0 This a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every Ib minutes. Legibly print and sign your name at the beginning of your shift. EFTA00120193  E.p.54e4n Suicide Watch Observation Log Nam of inmate on watch: Reg #: -4(D 3 lb - 054 Date: 1123 ici Time Observations: Briefly note your observations. Initial all entries. Initials 1 .• 4 0AMnry6e bra it- clown to cuicAe. cel 144 1 I ' 5A4 Inrndi-e 11in on bed zoom,' (lima i-e c_i-4-1-irn cn bed +(Ming 2'.I5Awi I nrrak obtenl-)i-, etiirna-e. -IK eA +c) MI h'Irn Z.30/44 inrrek. 3; 4ins nn bfr\ -Er{ ;no +0 remember 011-i-11- hCipferth 2'.115A1,4 Inrnaie Oi44-ii-13 on ted 3'.00Alvi Inmn-lt_. 6i-I-4-4 cn bed 3:15A0 ttve-, pici-ure.5 a lot-n(2146 -5.30At.4 nrirAe. (5i-I- ii on beyi 1 3. -46 Am Illmn-Fe- c5i-i--hio9 on bed 42.00Am Incrni-e ,5;-1-hog on 1-rd 4., ISAM I n)nai -e. ,ii-1--1in5 on bed 4. 30Am Inern4e c.5-1Cirdin9 af- door 401Kin k-45Am Ini-n(14-E (54nrriirn al- door 4-alic,e9 5'. 00 Ahl Inrri(11-e 5 i -I-Rry\ on bed 5.i5Anq Inmak. (.54ardi-1-9 al door 5.30Am Inmal-e. 3-1drt-jinS 04 door 5A-5Am I nnufe. L3-Ittry-lino 61- door (1)*.DONA Inrncrie ,3-1Cirdiri a4- door CD*. I5Am Inm°1-e_ _5-iandiry) (.4- door . (4)".30AIA Inry-n-Ve- 6 -1tArtIIrg 01+ docv (0'.45M4 Incnorl-e_ c.)1-arcling 01- hnor 4 %oc) Ann 1n mai-a, fi nding £ Claw' Note to all observers: Legibly print and sign your name at the beginning of your shift. 1 EFTA00120194