> i f t Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Register #: Institution: MCC Date Watch Began / Ended Z - Wy ONLY ITEMS ALLOWED Suicide Smock/Slippers Suicide Blanket Suicide Mattress Paper Cup/Soap SW Paper Spoon To be completed by Chief Psychologist at conclusion of watch: Booklet \ of ji SWCL - Tampons or Foam Belt/Napkin Finger Toothbrush INMATE EFTA00140505

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STAPLE LOCAL PROCEDURES HERE Check one of the following: 0 This is the initial log book for this suicide watch. Enter date and time watch began: _ ra This is a continuation log book for this watch. Enter date and time this watch book was initiated: -23-04 1. d0am © Instructions to Observer: Document your observations every _\Sy minutes. Legibly print and sign your name at the beginning of your shift. EFTA00140506

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PP37 OX Page | of I —— ee f ———— NYMBJ 531.01 * INMATE HISTORY * 4. 67-24-2019 PAGE 001 OF 001 * MED DY ST * 12:32:30 REG NO..: ME namc....: EPSTEIN, JEFFREY EDWARD CATEGORY: [MDS FUNCTION: [0IS FORMAT: | FCL ASSIGNMENT DESCRIPTION START DATE/TIME STOP DATE/TIME NYM NOT MED CL NOT MEDICALLY CLEARED 07-06-2019 2124 CURRENT NYM SUIC WATCH SUICIDE WATCH 07-23-2019 0140 07-24-2019 0845 G0005 TRANSACTION SUCCESSFULLY COMPLETED - CONTINUE PROCESSING IF DESIRED * https://bop.tcp.doj.gov:9049/SENTR Y/J1PP160.do 7/24/2019 EFTA00140507

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Suicide Watch Observation Log Name _of inmate * on Watch: 2D BLIZZ r Date: 7 /2 Time Observations: Briefly note your observations. Initial all entries. | Lana Ease tna Ez atin tease seeing on 0 le aly fh tee Lod Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140508

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Suicide Watch Observation Log Name of Inmate on watch: Sp £t4 Reg #: Date:O7- 23 4G Observations: Briefly note your observations. Initial all entries. g’ = . lam Attia fF Jd, CMC) Vitra \__2 Of “at a 2 Z r — eo, .: 450m -byenat> Spee <2 220%, —t7 4 was 2 , Sam 4: Wav CLT WA _- o~— ‘ak. “er -o -¥*. ORI Ce Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140509

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Suicide Watch Observation Log Ni f I te ame of Inma = 7227 [__ time |” _ovservtions: sriety note your observations. Ina allenries. | tiie _| 10300% wnat, Cipadein 1 xppecteg tetiiad — |e espe elle hcl guint te} \Zinrete Dprctein is 0a %ing Ie o£ Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140510

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Ese Reg +: IE vate: 7-25-14) Observations: Briefly note your observations. Initial all entries. | initiats | Es Me: - - @ = On wo hy ae psssunes S| (225 PONS.B.AC : on watch: Vi, abl GPSPEN bns Rebnod Guw C6oACm Tim GPSlew \S Wace, acute Le Py 0S. M_ PEN 1s 4FKKWS ppt Crane 20 oo EPSled is bnu blow ne 2g; ) =—PSkk 0) % Dd45 2a e Uieo ~ PJ. 20 |. WANS - 2530 SR ETIe 2 ov azns | Dim besten Pecans te Be Coat ——— | vg 22:3 | Dim cesses Stes fy Ge Saou, ——l QUMs Me END Su.eT Tie Ts00G BAS. * 2 Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140511

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Suicide Watch Observation Log Name of Inmate S, ate ee *4 ime__| Observations: riety note your observations. Initia allenvis. | Initiale _ ‘ > Me = AMAZE SE RQSTEIN DIARY FA ge KT | PIS > Inthe BPSTE ibis seepitp-—<— za RN Hanesshes eof ecpagey CALI : rane AS mi ; \} TS OER lets Fase eta Nout IB i “M1 amates 5% i Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140512

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Name of Inmate Suicide Watch Observation Log Fe . 7 Ob%0s ob Bp eis tess 2 oe Seth Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140513

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Suicide Watch Observation Log WM epeitt—< DSK OY) OSSe von SAIC Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140514