SOP_NUMBER: 209.06-att-1
TITLE: Offender Assignment to Segregation - Administrative Segregation Assignment Memo
REFERENCE_CODE: IIB09-0001
DIVISION: Facilities
TOPIC_AREA: Facilities Control/Discipline/Segregation
EFFECTIVE_DATE: 2021-02-19
WORD_COUNT: 191
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105941
URL: https://gps.press/sop-data/209.06-att-1/

SUMMARY:
This form documents the placement of an offender into administrative segregation, whether voluntary or involuntary. It requires staff to document the reasons for placement, assess whether the offender poses a direct threat to safety or facility operations, and includes a 24-hour review decision point where supervisors determine whether to return the offender to regular housing or maintain segregation pending a formal hearing. The form also documents that the offender received orientation to segregation unit rules.

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

ATTACHMENTS:
  1. Offender Assignment to Segregation - Administrative Segregation Assignment Memo
     URL: https://gps.press/sop-data/209.06-att-1/
  2. 96-Hour Segregation Hearing Report
     URL: https://gps.press/sop-data/209.06-att-2/
  3. A, Segregation_Isolation Checklist-12 Hour Shift
     URL: https://gps.press/sop-data/209.06-att-3/
  4. Administrative Segregation Assignment Appeal Form
     URL: https://gps.press/sop-data/209.06-att-4/
  5. 7-Day Segregation Status Review Form
     URL: https://gps.press/sop-data/209.06-att-5/
  6. Administrative Segregation Orientation Handout
     URL: https://gps.press/sop-data/209.06-att-6/

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FULL TEXT:
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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**<br>**in**<br>**Administrative**<br>**Segregation**<br>**(96-hour**<br>**Formal**<br>**Hearing**<br>**for**<br>**Initial**<br>**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.