Page 1 of 1 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 WardenHas 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? 7‘ 4 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