SOP 209.08-att-10: Administrative Segregation: Tier II Program Checklist - 30-Minute and 15-Minute Watch Form/Observation Record

Division:
Facilities
Effective Date:
April 11, 2015
Reference Code:
IIB09-0003
Topic Area:
209 Policy-Facilities Control/Discipline/Segregation
PowerDMS:
View on PowerDMS
Length:
108 words

Summary

This form is used to document observation and monitoring of offenders placed in Tier II administrative segregation who require either 30-minute or 15-minute watch intervals. Staff must record the time and their initials for each observation period throughout the day, seven days a week. The completed form is retained in the offender's case history file.

Key Topics

  • administrative segregation
  • Tier II program
  • offender observation
  • watch form
  • 30-minute watch
  • 15-minute watch
  • segregation monitoring
  • case history file
  • facility discipline
  • observation record

Full Text

Attachment 10
OFFENDER NAME: ______________ SOP 209.08 (IIB09-0003)
GDC#:___________________________ ADMINISTRATIVE SEGREGATION: TIER II PROGRAM CHECKLIST (04/11/15)
30-MINUTE OR 15-MINUTE WATCH FORM/OBSERVATION RECORD

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|MONDAY|MONDAY|TUESDAY|TUESDAY|WEDNESDAY|WEDNESDAY|THRUSDAY|THRUSDAY|FRIDAY|FRIDAY|SATURDAY|SATURDAY|SUNDAY|SUNDAY|
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RETENTION SCHEDULE: Upon completion of this form, it will be placed in the offender’s case history file.

Attachments (10)

  1. Tier II Program Assignment Recommendation and 1Initial Segregation Review (496 words)
  2. Administrative Segregation: Tier II Program Assignment Memo (124 words)
  3. Administrative Segregation: Tier II Program Assignment Appeal Form (160 words)
  4. Administration Segregation: Tier II Program Handout (1,207 words)
  5. Administrative Segregation: Tier II Program 90-Day Review (187 words)
  6. Administrative Segregation: Tier II Program 90 Day Review Assignment Appeal Form (149 words)
  7. Administrative Segregation: Tier II Program - Cell Check Sheet (110 words)
  8. Administrative Segregation: Tier II Program Checklist (212 words)
  9. Administrative Segregation: Tier II Program Checklist - 30-Minute and 15-Minute Watch Form/Observation Record (108 words)
  10. Administrative Segregation: Tier II Program Performance Recording Sheet (39 words)
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