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BP-A295.052 SPECIAL HOUSING UNIT REVIEW
APRIL 1994
Inmate Name:
EPSTEIN, JEFFREY EDWARD
Date Entered Special Housing:
07-29-2019 Register Number
76318-064 U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
Reason for Placement:
PENDING DHO FOR CODE 228 SELF-MUTILATION Institution:
NEW YORK MCC
I. Sutract (2 Cr 3 Days)
3 Day Review
Action Taken on the Above Date:
Continue in Special Housing Unit
Printed Name/Signature: Date Reviewed
08-01-2019
H. RECORD REVIEW.
(To be done weekly in the ornate's absence, beginning after the unperson 7 day review, and continuing every week between each in-person 30 day
review.)
DATE ACTION TAKEN REMARKS SIGNATURE
08-05-2019 Continue in Special Housing Unit
it Subsea: (7 or 30 Days)
7 Day Review Review 8y (SRO): Reviewing Authority:
Date inmate appeared for a Special Housing Review.
08-05-2019 Or Date inmate waived right to appear:
01-01-111
Has been seen daily by Medical Staff.
HAS been seen daily by responsible officer designated by Warden g Yes: ❑ No
Has received prescribed weekly exercise: WI Yet E Na
Proper documentation and justification in the Central File (Incident Report OHO Report, Copies of Special Housing Review Form) g Yes: ❑ No
if no, why not?
Is there a written psychiatric or psychological assessment on the inmate who has Spent 30 days in a special housing status? 1_.] Yes: ❑ No
Is there an additional assessment for every one month interval thereafter? P1 Yes: E NO
if no. why not? P1 Yes: El No
Action taken on the above date by the Segregation Review Official or the Reviewing Authority:
I;s71COntinbe in Special Housing iJ Released from Special Housing;
Did inmate in Administrative Detention receive a written copy of stairs decision and the basis for the finding at each 30 day review? g Yes; ❑ No
if no. why not (Should be given provided institutional woody not compromised)?
Remarks: (Any change in the reason for placement is bo be noted in this section. If the reason for placement changes the inmate must receive a copy of this
form):
Date of Next Resew:
08-12-2019
PriAtti Name and Signature of Segregation Renew Maud or the Reviewing Authority and Cobs Sigred.
Record Copy - Central File
That form replaces 8P-295(52) dated January 1988
file:///C:ftemp/shu/Epstein-Reno76318-054_SRO_20190729-20190810.html 8/13/2019
EFTA00036573