BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit: 5UNT MGR EXT-101 Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: H01-001L Inmate is In: N/A DS: N/A AD Status N/A Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-21-2019 Morn Y Y 07-21-2019 Day Y Y 07-21-2019 Eve Y Y 07-22-2019 Morn Y Y Y No 01:00 07-22-2019 Day Y Y 07-22-2019 Eve Y Y EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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 DOJ-OGR-00024610
Full Text
BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit: 5UNT MGR EXT-101 Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: H01-001L Inmate is In: N/A DS: N/A AD Status N/A Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-21-2019 Morn Y Y 07-21-2019 Day Y Y 07-21-2019 Eve Y Y 07-22-2019 Morn Y Y Y No 01:00 07-22-2019 Day Y Y 07-22-2019 Eve Y Y EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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 DOJ-OGR-00024610
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BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: Regular Unit: 5UNT MGR EXT Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel: N/A Time Rel: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z04-206LAD Inmate Is In: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 08-04-2019 Morn Y Y 08-04-2019 Day Y Y 08-04-2019 Eve Y Y 08-05-2019 Morn Y Y 08-05-2019 Day Y Y 08-05-2019 Eve Y Y 08-06-2019 Morn Y Y 08-06-2019 Day Y Y 08-06-2019 Eve Y Y No 08-07-2019 Morn Y Y 08-07-2019 Day Y Y 08-07-2019 Eve Y Y No 08-08-2019 Morn Y Y 08-08-2019 Day Y Y 08-08-2019 Eve Y Y 08-09-2019 Morn Y Y 08-09-2019 Day Y Y 08-09-2019 Eve Y Y EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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) Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011. DOJ-OGR-00024613
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BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit A&O UNIT MANAGER Cell: A&O Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z05-124LAD Inmate Is In: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature Morn B D S 07-08-2019 Morn Y (b)(7)(A) Day Eve 07-11-2019 Morn Y (b)(6), (b)(7)(A), (b)(7)(C) Day Y N Ref See 2nd page Eve Y 07-12-2019 Morn Y See 2nd page Day Y Eve Y 07-13-2019 Morn Y Day Y Eve Y EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive, etc. Meals/SH: Shower - Yes (Y); 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-Period 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 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 DOJ-OGR-00024606
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BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit: A&O Unit Manager Cell: A&O Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z05-124LAD Inmate is in: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-14-2019 Morn Y Y N No 07-14-2019 Day Y N No 07-14-2019 Eve Y N Y N No (b)(7)(A) (b)(7)(C) 07-15-2019 Morn Y Y No 01:00 See 2nd page 07-15-2019 Day Y Y No 07-15-2019 Eve Y N No 07-16-2019 Morn Y Y See 2nd page 07-16-2019 Day Y Y No 07-16-2019 Eve Y Y See 2nd page 07-17-2019 Morn Y Y Ref 01:00 See 2nd page 07-17-2019 Day Y Y Y No 07-17-2019 Eve Y Y No 07-18-2019 Morn Y Y Ref See 2nd page 07-18-2019 Day Y N Y No 07-18-2019 Eve Y Y See 2nd page 07-19-2019 Morn Y Y Y 00:15 See 2nd page 07-19-2019 Day Y Y Y 07-19-2019 Eve Y N Y No 07-20-2019 Morn Y Y N No 07-20-2019 Day Y Y 07-20-2019 Eve Y N Y N No EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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) Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011. DOJ-OGR-00024608
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BP-A0292 APR 15 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: Regular Unit: 5UNT MGR UNIT EXT UNIT Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Z04-206LAD Inmate Is In: N/A DS: N/A AD Status Special Housing Unit Cell Number: Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-29-2019 Morn Y N/A N/A N/A N/A N/A N/A N/A WBU (M7 (N/A) (H7)MCI 07-29-2019 Day 07-29-2019 Eve Y N N/A N/A N/A N/A N/A 07-30-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 07-30-2019 Day Y N Ref 07-30-2019 Eve Y No 07-31-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 07-31-2019 Day Y Y 05:30/07:30 O 02:00 See 2nd page 07-31-2019 Eve Y No 08-01-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 08-01-2019 Day Y N Ref 08-01-2019 Eve Y No 08-02-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 08-02-2019 Day Y Y No 01:00 See 2nd page 08-02-2019 Eve Y No 08-03-2019 Morn Y N/A N/A N/A N/A N/A N/A 08-03-2019 Day Y N 08-03-2019 Eve Y N No EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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 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. DOJ-OGR-00024611
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Page 997
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: _____________________________________
Regular Unit: _______ 5UNT MGR
(b)(6); (b)(7)(C)
XT (b)(6); (b)(7)(C)
Cell: 5
Violation or Reason: N/A
Date Rec'd: N/A
Admittance Authorized: N/A
Date Rel.: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
08-04-2019 Morn Y Y
08-04-2019 Day Y Y
08-04-2019 Eve Y Y
08-05-2019 Morn Y Y
08-05-2019 Day Y Y
08-05-2019 Eve Y Y
08-06-2019 Morn Y Y
08-06-2019 Day Y Y
08-06-2019 Eve Y No
08-07-2019 Morn Y Y
08-07-2019 Day Y Y
08-07-2019 Eve Y No
08-08-2019 Morn Y Y
08-08-2019 Day Y Y
08-08-2019 Eve Y Y
08-09-2019 Morn Y Y
08-09-2019 Day Y Y
08-09-2019 Eve Y Y
Morn
Day
Eve
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Time (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.
DOJ-OGR-00025241
--- PAGE BREAK ---
Page 1117
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: ____________________
Regular Unit: ____________________
SUNT MGR
EXT
Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-29
Time: 12:21
Rec'd: -
Rec'd: -
Admittance Authorized: (b)(6); (b)(7)(C)
Date: ____________________
Rel.: ____________________
Time: ____________________
Rel.: ____________________
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: DS: AD
AD Status: ____________________
Is Inmate on Medication: Y
Medical Department Notified: Y
Date
Shift
Meals
SH
Exercise
Out of cell time (Total min/hrs)
Comments
Medical Staff Sign
OIC Signature
B
D
S
08-04-2019
Morn
Y
08-04-2019
Day
Y
08-04-2019
Eve
Y
08-05-2019
Morn
Y
08-05-2019
Day
Y
08-05-2019
Eve
Y
08-06-2019
Morn
Y
08-06-2019
Day
Y
08-06-2019
Eve
Y
No
08-07-2019
Morn
Y
08-07-2019
Day
Y
08-07-2019
Eve
Y
No
08-08-2019
Morn
Y
08-08-2019
Day
Y
08-08-2019
Eve
Y
08-09-2019
Morn
Y
08-09-2019
Day
Y
08-09-2019
Eve
Y
Morn
Day
Eve
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Visit, (M) Medical, (C) Court, (O) Other - Yes (Y) if applicable / Enter Actual Time Period 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.
DOJ-OGR-00025339
--- PAGE BREAK ---
Page 1119
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: _____________________________________
Regular Unit: _______ SUNT MGR EXT _______ Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-29
Time: 12:21
Admittance Authorized: (b)(6); (b)(7)(C)
Date: _______
Time: _______
Pertinent Information: N/A
Rel.: _______
Rel.: _______
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: _______ DS: _______ AD _______ AD Status
Is Inmate on Medication: Y
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Morn B D S
Day
Eve
07-29-2019 Morn Y (b)(6); (b)(7)(C)
Day
07-29-2019 Eve Y N
07-30-2019 Morn Y (b)(6); (b)(7)(C)
Day Y N Ref See 2nd page
07-30-2019 Eve Y No
07-31-2019 Morn Y
Day Y Y 06:30/07:30 O 02:00 See 2nd page
07-31-2019 Eve Y No
08-01-2019 Morn Y
Day Y N Ref See 2nd page
08-01-2019 Eve Y No
08-02-2019 Morn Y
Day Y Y No 01:00 See 2nd page
08-02-2019 Eve Y No
08-03-2019 Morn Y
Day Y
08-03-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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. 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.
DOJ-OGR-00025341
--- PAGE BREAK ---
Page 1122
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: SUNT MGR
EXT
Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-10
Time: 15:26
Admittance Authorized: [redacted]
Date:
Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: H01-001L
Inmate Is In: DS: AD
Is Inmate on Medication: N
Medical Department Notified: Y
AD Status:
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
07-21-2019 Morn Y Y
07-21-2019 Day Y Y
07-21-2019 Eve Y Y
07-22-2019 Morn Y Y
07-22-2019 Day Y Y Y No 01:00
07-22-2019 Eve Y Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Time (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.
DOJ-OGR-00025344
--- PAGE BREAK ---
Page 1124
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: A&O
UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Violation or Reason: PENDING CLASSIFICATION
Date Rec'd: 2019-07-10
Time Rec'd: 15:26
Admittance Authorized: (b)(6); (b)(7)(C)
Date Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: DS: AD
AD Status
Is Inmate on Medication: N
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
07-14-2019 Morn Y Y No (b)(6); (b)(7)(C)
07-14-2019 Day Y N No
07-14-2019 Eve Y N No
07-15-2019 Morn Y Y No (b)(6); (b)(7)(C)
07-15-2019 Day Y Y No 01:00 See 2nd page
07-15-2019 Eve Y No No
07-16-2019 Morn Y Y See 2nd page
07-16-2019 Day Y Y See 2nd page
07-16-2019 Eve Y No No
07-17-2019 Morn Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y Ref 01:00 See 2nd page
07-17-2019 Eve Y No No
07-18-2019 Morn Y Y See 2nd page
07-18-2019 Day Y N Ref See 2nd page
07-18-2019 Eve Y No No
07-19-2019 Morn Y Y 00:15 See 2nd page
07-19-2019 Day Y Y 00:15 See 2nd page
07-19-2019 Eve Y Y
07-20-2019 Morn Y Y
07-20-2019 Day Y Y
07-20-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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.
DOJ-OGR-00025346
--- PAGE BREAK ---
Page 1127
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
A&ON: (b)(6); (b)(7)(C)
Regular Unit: UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Violation or Reason: PENDING CLASSIFICATION
Date Rec'd: 2019-07-07
Time Rec'd: 19:20
Admittance Authorized: (b)(6); (b)(7)(C)
Date Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: DS: AD
AD Status
Is Inmate on Medication: N
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Morn B D S
Day
Eve
07-08-2019 Morn Y
(b)(6); (b)(7)(C)
Day
Eve
Morn
Day
Eve
Morn
Day
Eve
07-11-2019 Morn Y
07-11-2019 Day Y N Ref See 2nd page (b)(6); (b)(7)(C)
07-11-2019 Eve Y
07-12-2019 Morn Y
07-12-2019 Day Y See 2nd page (b)(6); (b)(7)(C)
07-12-2019 Eve Y
07-13-2019 Morn Y
07-13-2019 Day Y
07-13-2019 Eve Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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. DOJ-OGR-00025349
--- PAGE BREAK ---
Page 2696
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
A&O (b)(6); (b)(7)(C)
UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Regular Unit:
Violation or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance Authorized: N/A
Date Rel.: N/A
Time Rel.: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
B D S
07-14-2019 Morn Y N No
07-14-2019 Day Y N No
07-14-2019 Eve Y N No (b)(6); (b)(7)(C)
07-15-2019 Morn Y Y No 01:00 See 2nd page
07-15-2019 Day Y Y
07-15-2019 Eve Y N
07-16-2019 Morn Y Y
07-16-2019 Day Y See 2nd page
07-16-2019 Eve Y Y No
07-17-2019 Morn Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y
07-17-2019 Eve Y Y No
07-18-2019 Morn Y N Ref
07-18-2019 Day Y N See 2nd page
07-18-2019 Eve Y Y No
07-19-2019 Morn Y Y Y 00:15 See 2nd page
07-19-2019 Day Y Y
07-19-2019 Eve Y Y
07-20-2019 Morn Y Y
07-20-2019 Day Y N
07-20-2019 Eve Y N N
EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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.
DOJ-OGR-00026352
--- PAGE BREAK ---
Page 3125
BP-A0292
APR 16
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
SPECIAL HOUSING UNIT RECORD
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: A&C
UNIT MANAGER
Cell: A&O
Violation or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance Date Rel: N/A
Authorized: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Mom
Day
Eve
07-08-2019 Mom Y
Day
Eve
Mom
Day
Eve
Mom
Day
Eve
07-11-2019 Mom Y
07-11-2019 Day Y N Ref See 2nd page
07-11-2019 Eve Y
07-12-2019 Mom Y
07-12-2019 Day Y
07-12-2019 Eve Y
See 2nd page
07-13-2019 Mom Y
07-13-2019 Day Y
07-13-2019 Eve Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assautive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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)
Prescribed by P5270
This form replaces BP-292(52) dated AUG 2011.
PDF
DOJ-OGR-00026765
--- PAGE BREAK ---
Page 3127
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker UNASSIGNED ADMISSION
Regular Unit: A&C
UNIT MANAGER A&O
Violation
or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance
Authorized: N/A
Date Rel: N/A
Time Rel: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status N/A
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
B D S
07-14-2019 Mom Y Y N No
07-14-2019 Day Y N No
07-14-2019 Eve Y N No
07-15-2019 Mom Y Y Y No 01:00 See 2nd page
07-15-2019 Day Y Y No
07-15-2019 Eve Y Y No
07-16-2019 Mom Y Y
07-16-2019 Day Y See 2nd page
07-16-2019 Eve Y
07-17-2019 Mom Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y
07-17-2019 Eve Y No
07-18-2019 Mom Y Y Ref See 2nd page
07-18-2019 Day Y N Ref 01:00 See 2nd page
07-18-2019 Eve Y No
07-19-2019 Mom Y Y Y 00:15 See 2nd page
07-19-2019 Day Y
07-19-2019 Eve Y
07-20-2019 Mom Y Y
07-20-2019 Day Y N No
07-20-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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)
Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011.
PDF DOJ-OGR-00026767
Individual Pages
Page 1 - DOJ-OGR-00024610
Page 2 - DOJ-OGR-00024613
BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: Regular Unit: 5UNT MGR EXT Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel: N/A Time Rel: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z04-206LAD Inmate Is In: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 08-04-2019 Morn Y Y 08-04-2019 Day Y Y 08-04-2019 Eve Y Y 08-05-2019 Morn Y Y 08-05-2019 Day Y Y 08-05-2019 Eve Y Y 08-06-2019 Morn Y Y 08-06-2019 Day Y Y 08-06-2019 Eve Y Y No 08-07-2019 Morn Y Y 08-07-2019 Day Y Y 08-07-2019 Eve Y Y No 08-08-2019 Morn Y Y 08-08-2019 Day Y Y 08-08-2019 Eve Y Y 08-09-2019 Morn Y Y 08-09-2019 Day Y Y 08-09-2019 Eve Y Y EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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) Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011. DOJ-OGR-00024613
Page 1 - DOJ-OGR-00024606
BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit A&O UNIT MANAGER Cell: A&O Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z05-124LAD Inmate Is In: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature Morn B D S 07-08-2019 Morn Y (b)(7)(A) Day Eve 07-11-2019 Morn Y (b)(6), (b)(7)(A), (b)(7)(C) Day Y N Ref See 2nd page Eve Y 07-12-2019 Morn Y See 2nd page Day Y Eve Y 07-13-2019 Morn Y Day Y Eve Y EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive, etc. Meals/SH: Shower - Yes (Y); 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-Period 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 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 DOJ-OGR-00024606
Page 1 - DOJ-OGR-00024608
BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: UNASSIGNED ADMISSION Regular Unit: A&O Unit Manager Cell: A&O Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Special Housing Unit Cell Number: Z05-124LAD Inmate is in: N/A DS: N/A AD Status Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-14-2019 Morn Y Y N No 07-14-2019 Day Y N No 07-14-2019 Eve Y N Y N No (b)(7)(A) (b)(7)(C) 07-15-2019 Morn Y Y No 01:00 See 2nd page 07-15-2019 Day Y Y No 07-15-2019 Eve Y N No 07-16-2019 Morn Y Y See 2nd page 07-16-2019 Day Y Y No 07-16-2019 Eve Y Y See 2nd page 07-17-2019 Morn Y Y Ref 01:00 See 2nd page 07-17-2019 Day Y Y Y No 07-17-2019 Eve Y Y No 07-18-2019 Morn Y Y Ref See 2nd page 07-18-2019 Day Y N Y No 07-18-2019 Eve Y Y See 2nd page 07-19-2019 Morn Y Y Y 00:15 See 2nd page 07-19-2019 Day Y Y Y 07-19-2019 Eve Y N Y No 07-20-2019 Morn Y Y N No 07-20-2019 Day Y Y 07-20-2019 Eve Y N Y N No EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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) Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011. DOJ-OGR-00024608
Page 1 - DOJ-OGR-00024611
BP-A0292 APR 15 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. 76318-054 Team/caseworker: Regular Unit: 5UNT MGR UNIT EXT UNIT Cell: 5 Violation or Reason: N/A Date Rec'd: N/A Time Rec'd: N/A Admittance Authorized: N/A Date Rel.: N/A Time Rel.: N/A Pertinent Information: N/A Separation Information: N/A Z04-206LAD Inmate Is In: N/A DS: N/A AD Status Special Housing Unit Cell Number: Is Inmate on Medication: N/A Medical Department Notified: N/A Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B D S 07-29-2019 Morn Y N/A N/A N/A N/A N/A N/A N/A WBU (M7 (N/A) (H7)MCI 07-29-2019 Day 07-29-2019 Eve Y N N/A N/A N/A N/A N/A 07-30-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 07-30-2019 Day Y N Ref 07-30-2019 Eve Y No 07-31-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 07-31-2019 Day Y Y 05:30/07:30 O 02:00 See 2nd page 07-31-2019 Eve Y No 08-01-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 08-01-2019 Day Y N Ref 08-01-2019 Eve Y No 08-02-2019 Morn Y N/A N/A N/A N/A N/A N/A See 2nd page 08-02-2019 Day Y Y No 01:00 See 2nd page 08-02-2019 Eve Y No 08-03-2019 Morn Y N/A N/A N/A N/A N/A N/A 08-03-2019 Day Y N 08-03-2019 Eve Y N No EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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 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. DOJ-OGR-00024611
Page 997 - DOJ-OGR-00025241
Page 997
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: _____________________________________
Regular Unit: _______ 5UNT MGR
(b)(6); (b)(7)(C)
XT (b)(6); (b)(7)(C)
Cell: 5
Violation or Reason: N/A
Date Rec'd: N/A
Admittance Authorized: N/A
Date Rel.: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
08-04-2019 Morn Y Y
08-04-2019 Day Y Y
08-04-2019 Eve Y Y
08-05-2019 Morn Y Y
08-05-2019 Day Y Y
08-05-2019 Eve Y Y
08-06-2019 Morn Y Y
08-06-2019 Day Y Y
08-06-2019 Eve Y No
08-07-2019 Morn Y Y
08-07-2019 Day Y Y
08-07-2019 Eve Y No
08-08-2019 Morn Y Y
08-08-2019 Day Y Y
08-08-2019 Eve Y Y
08-09-2019 Morn Y Y
08-09-2019 Day Y Y
08-09-2019 Eve Y Y
Morn
Day
Eve
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Time (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.
DOJ-OGR-00025241
Page 1117 - DOJ-OGR-00025339
Page 1117
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: ____________________
Regular Unit: ____________________
SUNT MGR
EXT
Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-29
Time: 12:21
Rec'd: -
Rec'd: -
Admittance Authorized: (b)(6); (b)(7)(C)
Date: ____________________
Rel.: ____________________
Time: ____________________
Rel.: ____________________
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: DS: AD
AD Status: ____________________
Is Inmate on Medication: Y
Medical Department Notified: Y
Date
Shift
Meals
SH
Exercise
Out of cell time (Total min/hrs)
Comments
Medical Staff Sign
OIC Signature
B
D
S
08-04-2019
Morn
Y
08-04-2019
Day
Y
08-04-2019
Eve
Y
08-05-2019
Morn
Y
08-05-2019
Day
Y
08-05-2019
Eve
Y
08-06-2019
Morn
Y
08-06-2019
Day
Y
08-06-2019
Eve
Y
No
08-07-2019
Morn
Y
08-07-2019
Day
Y
08-07-2019
Eve
Y
No
08-08-2019
Morn
Y
08-08-2019
Day
Y
08-08-2019
Eve
Y
08-09-2019
Morn
Y
08-09-2019
Day
Y
08-09-2019
Eve
Y
Morn
Day
Eve
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Visit, (M) Medical, (C) Court, (O) Other - Yes (Y) if applicable / Enter Actual Time Period 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.
DOJ-OGR-00025339
Page 1119 - DOJ-OGR-00025341
Page 1119
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: _____________________________________
Regular Unit: _______ SUNT MGR EXT _______ Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-29
Time: 12:21
Admittance Authorized: (b)(6); (b)(7)(C)
Date: _______
Time: _______
Pertinent Information: N/A
Rel.: _______
Rel.: _______
Separation Information: N/A
Special Housing Unit Cell Number: Z04-206LAD
Inmate Is In: _______ DS: _______ AD _______ AD Status
Is Inmate on Medication: Y
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Morn B D S
Day
Eve
07-29-2019 Morn Y (b)(6); (b)(7)(C)
Day
07-29-2019 Eve Y N
07-30-2019 Morn Y (b)(6); (b)(7)(C)
Day Y N Ref See 2nd page
07-30-2019 Eve Y No
07-31-2019 Morn Y
Day Y Y 06:30/07:30 O 02:00 See 2nd page
07-31-2019 Eve Y No
08-01-2019 Morn Y
Day Y N Ref See 2nd page
08-01-2019 Eve Y No
08-02-2019 Morn Y
Day Y Y No 01:00 See 2nd page
08-02-2019 Eve Y No
08-03-2019 Morn Y
Day Y
08-03-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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. 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.
DOJ-OGR-00025341
Page 1122 - DOJ-OGR-00025344
Page 1122
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: SUNT MGR
EXT
Cell: 5
Violation or Reason: PENDING CLASSIFICATION
Date: 2019-07-10
Time: 15:26
Admittance Authorized: [redacted]
Date:
Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: H01-001L
Inmate Is In: DS: AD
Is Inmate on Medication: N
Medical Department Notified: Y
AD Status:
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
07-21-2019 Morn Y Y
07-21-2019 Day Y Y
07-21-2019 Eve Y Y
07-22-2019 Morn Y Y
07-22-2019 Day Y Y Y No 01:00
07-22-2019 Eve Y Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period Start and End Time (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.
DOJ-OGR-00025344
Page 1124 - DOJ-OGR-00025346
Page 1124
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: A&O
UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Violation or Reason: PENDING CLASSIFICATION
Date Rec'd: 2019-07-10
Time Rec'd: 15:26
Admittance Authorized: (b)(6); (b)(7)(C)
Date Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: DS: AD
AD Status
Is Inmate on Medication: N
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
07-14-2019 Morn Y Y No (b)(6); (b)(7)(C)
07-14-2019 Day Y N No
07-14-2019 Eve Y N No
07-15-2019 Morn Y Y No (b)(6); (b)(7)(C)
07-15-2019 Day Y Y No 01:00 See 2nd page
07-15-2019 Eve Y No No
07-16-2019 Morn Y Y See 2nd page
07-16-2019 Day Y Y See 2nd page
07-16-2019 Eve Y No No
07-17-2019 Morn Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y Ref 01:00 See 2nd page
07-17-2019 Eve Y No No
07-18-2019 Morn Y Y See 2nd page
07-18-2019 Day Y N Ref See 2nd page
07-18-2019 Eve Y No No
07-19-2019 Morn Y Y 00:15 See 2nd page
07-19-2019 Day Y Y 00:15 See 2nd page
07-19-2019 Eve Y Y
07-20-2019 Morn Y Y
07-20-2019 Day Y Y
07-20-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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.
DOJ-OGR-00025346
Page 1127 - DOJ-OGR-00025349
Page 1127
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
A&ON: (b)(6); (b)(7)(C)
Regular Unit: UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Violation or Reason: PENDING CLASSIFICATION
Date Rec'd: 2019-07-07
Time Rec'd: 19:20
Admittance Authorized: (b)(6); (b)(7)(C)
Date Rel.:
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: DS: AD
AD Status
Is Inmate on Medication: N
Medical Department Notified: Y
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Morn B D S
Day
Eve
07-08-2019 Morn Y
(b)(6); (b)(7)(C)
Day
Eve
Morn
Day
Eve
Morn
Day
Eve
07-11-2019 Morn Y
07-11-2019 Day Y N Ref See 2nd page (b)(6); (b)(7)(C)
07-11-2019 Eve Y
07-12-2019 Morn Y
07-12-2019 Day Y See 2nd page (b)(6); (b)(7)(C)
07-12-2019 Eve Y
07-13-2019 Morn Y
07-13-2019 Day Y
07-13-2019 Eve Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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. DOJ-OGR-00025349
Page 2696 - DOJ-OGR-00026352
Page 2696
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
A&O (b)(6); (b)(7)(C)
UNIT MANAGER (b)(6); (b)(7)(C)
Cell: A&O
Regular Unit:
Violation or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance Authorized: N/A
Date Rel.: N/A
Time Rel.: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
B D S
07-14-2019 Morn Y N No
07-14-2019 Day Y N No
07-14-2019 Eve Y N No (b)(6); (b)(7)(C)
07-15-2019 Morn Y Y No 01:00 See 2nd page
07-15-2019 Day Y Y
07-15-2019 Eve Y N
07-16-2019 Morn Y Y
07-16-2019 Day Y See 2nd page
07-16-2019 Eve Y Y No
07-17-2019 Morn Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y
07-17-2019 Eve Y Y No
07-18-2019 Morn Y N Ref
07-18-2019 Day Y N See 2nd page
07-18-2019 Eve Y Y No
07-19-2019 Morn Y Y Y 00:15 See 2nd page
07-19-2019 Day Y Y
07-19-2019 Eve Y Y
07-20-2019 Morn Y Y
07-20-2019 Day Y N
07-20-2019 Eve Y N N
EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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.
DOJ-OGR-00026352
Page 3125 - DOJ-OGR-00026765
Page 3125
BP-A0292
APR 16
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
SPECIAL HOUSING UNIT RECORD
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker: UNASSIGNED ADMISSION
Regular Unit: A&C
UNIT MANAGER
Cell: A&O
Violation or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance Date Rel: N/A
Authorized: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number: Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
Mom
Day
Eve
07-08-2019 Mom Y
Day
Eve
Mom
Day
Eve
Mom
Day
Eve
07-11-2019 Mom Y
07-11-2019 Day Y N Ref See 2nd page
07-11-2019 Eve Y
07-12-2019 Mom Y
07-12-2019 Day Y
07-12-2019 Eve Y
See 2nd page
07-13-2019 Mom Y
07-13-2019 Day Y
07-13-2019 Eve Y
EXPLANATORY NOTES: Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assautive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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)
Prescribed by P5270
This form replaces BP-292(52) dated AUG 2011.
PDF
DOJ-OGR-00026765
Page 3127 - DOJ-OGR-00026767
Page 3127
BP-A0292
APR 16
SPECIAL HOUSING UNIT RECORD
U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
NEW YORK MCC
(Institution)
Inmate Name: EPSTEIN, JEFFREY EDWARD
Reg. No. 76318-054
Team/caseworker UNASSIGNED ADMISSION
Regular Unit: A&C
UNIT MANAGER A&O
Violation
or Reason: N/A
Date Rec'd: N/A
Time Rec'd: N/A
Admittance
Authorized: N/A
Date Rel: N/A
Time Rel: N/A
Pertinent Information: N/A
Separation Information: N/A
Special Housing Unit Cell Number Z05-124LAD
Inmate Is In: N/A
DS: N/A
AD Status N/A
Is Inmate on Medication: N/A
Medical Department Notified: N/A
Date Shift Meals SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature
B D S
07-14-2019 Mom Y Y N No
07-14-2019 Day Y N No
07-14-2019 Eve Y N No
07-15-2019 Mom Y Y Y No 01:00 See 2nd page
07-15-2019 Day Y Y No
07-15-2019 Eve Y Y No
07-16-2019 Mom Y Y
07-16-2019 Day Y See 2nd page
07-16-2019 Eve Y
07-17-2019 Mom Y Y Ref 01:00 See 2nd page
07-17-2019 Day Y Y
07-17-2019 Eve Y No
07-18-2019 Mom Y Y Ref See 2nd page
07-18-2019 Day Y N Ref 01:00 See 2nd page
07-18-2019 Eve Y No
07-19-2019 Mom Y Y Y 00:15 See 2nd page
07-19-2019 Day Y
07-19-2019 Eve Y
07-20-2019 Mom Y Y
07-20-2019 Day Y N No
07-20-2019 Eve Y N No
EXPLANATORY NOTES: Pertinent Info: I.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y); 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 Period 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)
Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011.
PDF DOJ-OGR-00026767