BP-A0292 APR 16 U.S. DEPARTMENT OF JUSTICE SPECIAL HOUSING UNIT RECORD FEDERAL BUREAU OF PRIGONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No._ 76318-054 Teamicasoworker. UNASSIGNED ADMISSION Regular Unit AOR. unit manacer x | Violation PENDING CLASSIFICATIO: Date Time i] or Reason: NOIN 7 Rec'd: 2019-07-10 — Recs: __ 15:28 Admittance Date Time Authorized: | Rel.: Rel.: NIA Pertinent Information: Separation Information: N/A Special Housing Unit Cell Number: 205-124LAD Inmate Is In: DS: AD AD Status N Is Inmate on Medication: Medica! Department Notified: Y Out of cell time Medical Date Shift Meals SH | Exercise c Staff Sign OIC Signature B O'S {Total min/hrs) omments 7-14-2019 | Morn Y Day Y N | No 07-14-2019 | Eve Y N | No 07-18-2019 Morn | ¥ O71 9) Day Y Y | No 01:00 See 2nd page 07-15-2019 | Eve ¥ No 07-16-2019 Morn Y 07-16-2019 | Day Y See 2nd page 07-16-2019 | Eve Y No 07-17-2019 | Morn Y 07-17-2019 | Day Y Y | Ref 01:00 See 2nd page 07-17-2019 | Eve Y No 07-18-2019 | Morn Y 07-18-2019 | Day Y N Ref See 2nd page 07-18-2019 | Eve Y No 07-19-2019 | Morn Y 07-19-2019 Day Y Y 00:15 See 2nd page 07-19-2019 | Eve y 07-20-2019 Morn | y 07-20-2013 | Day Y 07-20-2019 | Eve y| N [No EXPLANATORYNOTES 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, (0) 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. EFTA00036585

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07-15-2019 07-16-2019 07-17-2019 07-18-2019 07-19-2019 Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints Day shift comments: Health: Voices no medical complaints. EFTA00036586