EFTA00036581

Inmate Is In: BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Inmate Name: EPSTEIN, JEFFREY EDWARD Tearn/caseworker. NEW YORK MCC (Institution) Reg. No. 76318.054 Regular Unit: 5UNT MGR. 5 Violation Date Time PENDING CLASSIFICATION 2019-07-29 12:21 or Reason: Redd: Redd: Admittance Date Time Authorized: Rel.: Ret.: Pertinent Informabon: N/A Separation Information: Nth Special Housing Unit Cell Numbs: Z04.206LAD Is Inmate on Medication: Y Medical Department Notified: Date Shift Meals SH Examise Out of cell time (Total minfirs) Comments Medical Staff Sign OIC Signature B D S OB-04-2019 Mum Y CS-04-2019 Day y osea-2019 Eve y 1:6454019 mom y 06-05.2019 Day y oseszoia CO.011.2019 Eve Mom y y 03-011.2019 Day Y 06-062019 Eve y No Ce07.2019 Morn y IS07.2019 Day v Ce07.2019 Eve y No osee-zoia Mom y CO-08-2019 Day v osee-zoia 126-094019 Eve Mom y y CO494019 Day y 06-08-2019 Eve y Morn Day Eve AD AD Status DS: Y EXPLANATORYNOTES:Pertlnent Info: i e.. Epileptic. Diabetic; Suicidal; Assaultive: etc. Meas/SH: Shower - Yes (t): 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 Pedod 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 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. EFTA00036581