EFTA00036572.pdf

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BP-A295.052 SPECIAL HOUSING UNIT REVIEW U.S. DEPARTMENT OF JUSTICE
APRIL 1994 FEDERAL BUREAU OF PRISONS
Inmate Name: Register Number: Unit: Institution:
EPSTEIN, JEFFREY EDWARD 76318-054 5 NEW YORK MCC
Date Entered Special Housing: Reason for Placement:
07-10-2019 PENDING CAPTIANS REVIEW
I. Subject: (2 or 3 Days) Date Reviewed
3 Day Review 07-15-2019
Action Taken on the Above Date:
Continue in Special Housing Unit
Printed Name/Signature:
[REDACTED]
II. RECORD REVIEW.
(To be done weekly in the inmate's absence, beginning after the in-person 7 day review, and continuing every week between each in-person 30 day
review.)
DATE ACTION TAKEN REMARKS SIGNATURE
07-19-2019 Continue in Special Housing Unit [REDACTED]
III. Subject: (7 or 30 Days) Review By (SRO): Reviewing Authority:
7 Day Review [REDACTED]
Date inmate appeared for a Special Housing Review: Or Date inmate waived right to appear:
07-19-2019 01-01-111
Has been seen daily by Medical Staff: [Checked] Yes; [Unchecked] No
Has been seen daily by responsible officer designated by Warden: [Checked] Yes; [Unchecked] No
Has received prescribed weekly exercise: [Checked] Yes; [Unchecked] No
Proper documentation and justification in the Central File (Incident Report, DHO Report, copies of Special Housing Review Form): [Checked] Yes; [Unchecked] No
if no, why not?
Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housing status? [Checked] Yes; [Unchecked] No
Is there an additional assessment for every one month interval thereafter? [Checked] Yes; [Unchecked] No
if no, why not?
Action taken on the above date by the Segregation Review Official or the Reviewing Authority:
[Unchecked] Released from Special Housing; [Checked] Continue in Special Housing
Did inmate in Administrative Detention receive a written copy of staff's decision and the basis for the finding at each 30 day review? [Checked] Yes; [Unchecked] No
if no, why not (Should be given provided institutional security not compromised)?
Remarks: (Any 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
Printed Name and Signature of Segregation Review Official or the Reviewing Authority and Date Signed:
[REDACTED]
Record Copy - Central File
This form replaces BP-295(52) dated January 1988
file:///C:/temp/shu/Epstein-Reno76318-054_SRO_20190710-20190723.html 8/13/2019
EFTA00036572