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BP-A295.052 SPECIAL HOUSING UNIT REVIEW
APRIL 1994 U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
wave Name
EPSTEIN, JEFFREY EDWARD
Date Entered Special Housing:
07-10-2019 Register Number
76318-054 Unit
5
Reason for Placement
PENDING CAPTIANS REVIEW Institution
NEW YORK MCC
1. Subject: (2 or 3 Days)
3 Day Review Date Reviewed
07-15-2019
Action Taken on the Above Date:
Continue in Special Housing Unit
Printed Name/Signature:
II. RECORD REVIEW.
(To to done weekly in the inmates absence, beginning after the in-person 7 day review, and cord nuing every week between each in-person 30 day
review.)
DATE ACTION TAKEN REMARKS SIGNATURE
07-19-2019 Continue in Special Housing Unit
III. Subject (7 or 30 Days)
7 Day Review Review By (SRO): Reviewing Authority:
Date inmate appeared for a Speoal Housing Review:
07.19.2019 Or Date inmate waived right to appear
01-01-111
Has been seen daily by Medical Staff Yes: El No
Has been seen daily by responsible officer designated by Warden-
Has received prescribed weekly exercise: RI Yes: ICI No
Proper documentation and jusecation In the Central File (Incident Report. OHO Report copies of Special Housing Review Form): g Yes; ❑ No
if no, why not? Yes; ❑No
Is there a written psychiatric a psychologal assessment on the inmate who has spent 30 days in a special housing status? g yes; D No
Is there an additional assessment for every one month interval thereafter? 47‘1 Yet CI No
if no, why not?
Action taken on the above date by the Segregation Review Official or the Reviewing Authority:
❑ Released from Special Housng; WI Continue in Special Hoeing
Did inmate In Administrative Deletion receive a written copy of Staffs decision and the basis for the finding at each 30 day review? Yes; ❑ No
if no, why not (Should be given provided institutional security not compromised)?
Remarks: (My 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
PrEntPa Marne' and Sin nature of Segregation Review Official or the Reviewing Authority and Date Signed:
Record Copy Central Fie
This form replaces BP-295(52) dated January 1988
file:///C:/temp/shu/Epstein-Reno76318-054_SRO_20190710-20190723.html 8/13/2019
EFTA00036572