SOP 209.06-att-1: Offender Assignment to Segregation - Administrative Segregation Assignment Memo
Summary
Key Topics
- administrative segregation
- segregation assignment
- offender placement
- involuntary segregation
- voluntary segregation
- threat assessment
- facility safety
- segregation memo
- 24-hour review
- segregation hearing
- segregation unit orientation
- disciplinary housing
Full Text
SOP 209.06
Attachment 1
2/19/21
Administrative Segregation
Assignment Memo
FACILITY/CENTER: ___________________________________________
TO: Deputy Warden/Assistant Superintendent/Unit Manager/Duty Officer Date: _____________
RE: Administrative Segregation Time: _____________
Offender: ______________________________________________________________Number: ________________________
Present Assignment: _____________________________________________________________________________________
The offender named above was placed in Administrative Segregation on the above date for the reasons indicated:
Voluntary: _____________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Involuntary: ____________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
This offender poses a direct threat to the safety of others or himself/herself or poses a clear threat to the secure
operations of the facility. (please circle) yes/no
Date: ______________ Signature of Officer authorizing action: ____________________________________________
Deputy Warden/Assistant Superintendent/Unit Manager/Duty Officer 24-Hour Review Decision:
|Col1|Return Offender to appropriate housing assignment.|
|---|---|
||Remain
in
Administrative
Segregation
(96-hour
Formal
Hearing
for
Initial
Voluntary/Involuntary Assignment to Administrative Segregation to follow).|
Deputy Warden/Assistant Superintendent/Unit Manager/Duty Officer Signature:
________________________________________
Date: ________________________
The offender named above was given orientation to the Administrative Segregation unit.
I understand the orientation and that I will be held accountable for any violations of Administrative Segregation Unit rules.
Offender's Signature: _____________________________________________ Date: _____________________
CC. Warden
Offender
Retention Schedule: Upon completion, this form shall be placed in the offender's institutional file and maintained according to the official records
retention schedule for that file.