Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Epsi« a Register #: , TUBE: SY Institution: Date Watch Began / Ended 1423114 ONLY ITEMS ALLOWED Sack Meal Suicide Smock/Slippers To be completed by Chief Psychologist at conclusion of watch Booklet ___ of = 3 a © - a F S wu wo Y sa] ES 2 a % 5 £ 2Ea ‘c Hes £8 oO WG geo se -_—--— YY Os 2% LF aat SS a O08 G nnawn & SWCL - INMATE EFTA00120189

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STAPLE LOCAL PROCEDURES HERE Check one of the following: Oo This is the initial log book for this suicide watch. Enter date and time watch began: o 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

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Suicide Watch Observation Log ai S tT Sad Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00120191

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Suicide Watch Chronological Log Staff Suicide Watch Observers Only Name of inmate on watch: Epste inv). Register #: 46 3ip,-054 Institution: Mec, New Yer« Date Watch Began / Ended duly 23,2019 - July 24, a0q To be completed by Chief Psychologist at conclusion of watch: Booklet ____ of SWCL - STAFF EFTA00120192

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STAPLE LOCAL PROCEDURES HERE Check one of the following: vi This is the initial log book for this suicide watch. Enter date and time watch began: Suly 23,2010 at t4oam Oo This a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every 15 minutes. Legibly print and sign your name at the beginning of your shift. EFTA00120193

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vey, nate slanting, at doe 9 o'. OD AM lonale Stop at docx Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00120194