SOP_NUMBER: 209.08-att-11
TITLE: Administrative Segregation: Tier II Program Performance Recording Sheet
REFERENCE_CODE: IIB09-0003
DIVISION: Facilities
TOPIC_AREA: 209 Policy-Facilities Control/Discipline/Segregation
EFFECTIVE_DATE: 2016-04-11
WORD_COUNT: 39
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105954
URL: https://gps.press/sop-data/209.08-att-11/

SUMMARY:
This is a recording form used to document an offender's performance and progress while in the Tier II Administrative Segregation program. Staff members record daily observations and behavioral information for each segregated offender, with entries dated and signed by supervising staff. The completed form is filed in the offender's case history file for record-keeping and review purposes.

KEY_TOPICS: administrative segregation, tier II program, performance recording, offender behavior, disciplinary segregation, case file documentation, segregation monitoring, offender progress tracking

ATTACHMENTS:
  1. Tier II Program Assignment Recommendation and 1Initial Segregation Review
     URL: https://gps.press/sop-data/209.08-att-1/
  2. Administrative Segregation: Tier II Program Assignment Memo
     URL: https://gps.press/sop-data/209.08-att-2/
  3. Administrative Segregation: Tier II Program Assignment Appeal Form
     URL: https://gps.press/sop-data/209.08-att-3/
  4. Administration Segregation: Tier II Program Handout
     URL: https://gps.press/sop-data/209.08-att-4/
  5. Administrative Segregation: Tier II Program 90-Day Review
     URL: https://gps.press/sop-data/209.08-att-5/
  7. Administrative Segregation: Tier II Program 90 Day Review Assignment Appeal Form
     URL: https://gps.press/sop-data/209.08-att-7/
  8. Administrative Segregation: Tier II Program - Cell Check Sheet
     URL: https://gps.press/sop-data/209.08-att-8/
  9. Administrative Segregation: Tier II Program Checklist
     URL: https://gps.press/sop-data/209.08-att-9/
  10. Administrative Segregation: Tier II Program Checklist - 30-Minute and 15-Minute Watch Form/Observation Record
     URL: https://gps.press/sop-data/209.08-att-10/
  11. Administrative Segregation: Tier II Program Performance Recording Sheet
     URL: https://gps.press/sop-data/209.08-att-11/

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FULL TEXT:
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**Attachment 11**
**SOP 209.08 (IIB09-0003)**
**(04/11/16)**
# **ADMINISTRATIVE SEGREGATION: TIER II PROGRAM** **Performance Recording Sheet**


**Offender Name: _________________________________  GDC #:______________________**

|Date|Information|Staff Signature|
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**RETENTION SCHEDULE:  Upon completion of this form, it shall be placed in the offender case history file.**