SOP 209.04-att-1: Use of Force Supplement Report

Division:
Facilities
Effective Date:
February 18, 2021
Reference Code:
IIB08-0001
Topic Area:
209 Policy-Facilities Control/Discipline/Segregation
PowerDMS:
View on PowerDMS
Length:
113 words

Summary

This form documents incidents involving use of force or assault by offenders within GDC facilities. Staff completing the form must describe the circumstances leading to the incident, specify the type and extent of force used (including any equipment or less lethal weapons), and indicate whether criminal prosecution should be considered. The completed report is retained in the offender's institutional file according to official retention schedules.

Key Topics

  • use of force
  • assault by offender
  • force incident report
  • less lethal weapons
  • officer safety
  • restraints
  • incident documentation
  • facility control
  • disciplinary action
  • offender conduct violation

Full Text

SOP 209.04
Attachment 1

2/18/21

GEORGIA DEPARTMENT OF CORRECTIONS

USE OF FORCE SUPPLEMENT REPORT
I. Identification:

Facility/Center_______________________________________________________________________________

Offender: ______________________________________GDC Number: ________________________

II. Officer's Report:

A. Circumstances Leading to Use of Force or Assault by Offender:

Time of Incident: _____________________________ Date of Incident: ________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

B. Type and Extent of Forceful Action (Include Equipment Employed, if any):

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

________________________________________________________________________________ ___________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Less Lethal Weapon Used: __________________________ Certification Date: ____________________________

C. Complete (if applicable) by staff member if assaulted by offender. Do you feel that the Offender(s)
should be considered for criminal prosecution?

() Yes () No

D. __________________________________________ ____________________________________________
Name Title
___________________________________________ ____________________________________________
Signature Date

Retention Schedule: Upon completion, this form shall be retained in the offender’s institutional file and retained according
to the official retention schedule for that file.

Attachments (6)

  1. Use of Force Supplement Report (113 words)
  2. Use of Force Incident Report (310 words)
  3. Use of Force Coversheet_Checklist (198 words)
  4. Conducted Electrical Weapon (Taser) Weekly Usage Report Example (81 words)
  5. Official Witness Statement Form (642 words)
  6. Restraint Chair Authorization Form (109 words)
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