SOP_NUMBER: 209.10-att-1 TITLE: Drug Screen - Chain of Custody Form REFERENCE_CODE: IIB01-0024 DIVISION: Facilities TOPIC_AREA: 209 Policy-Facilities Control/Discipline/Segregation EFFECTIVE_DATE: 2015-04-30 WORD_COUNT: 303 POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105974 URL: https://gps.press/sop-data/209.10-att-1/ SUMMARY: This form documents the chain of custody for urine drug screening samples collected from inmates and probationers in GDC facilities. It requires the inmate's signature confirming the sample is their own and has not been tampered with, staff initials verifying sealing or testing in the inmate's presence, and tracks test results for various controlled substances. The form is used to document refusals to provide samples and becomes part of disciplinary packages when results are positive. KEY_TOPICS: drug screening, chain of custody, urine sample, drug test, controlled substances, cocaine, cannabis, methamphetamine, opiates, barbiturates, amphetamines, sample collection, inmate discipline, testing documentation, specimen handling ATTACHMENTS: 1. Drug Screen - Chain of Custody Form URL: https://gps.press/sop-data/209.10-att-1/ ======================================================================== FULL TEXT: ======================================================================== 4/30/15 DRUG SCREEN- CHAIN OF CUSTODY Attachment #1 SOP IIB01-0024 (209.10) |1. Inmate's/Probationer's signature beside (2) indicates:
-- the urine sample is my own;
-- the sample has not been tampered with by me or anyone else;
-- either the container has been sealed in my presence or the sample has been
tested in my presence.
2. STAFF INITIALS beside inmate's/probationer's name and number indicates the staff
member either sealed or tested the sample in the inmate's/probationer's presence.
3. "REF" beside inmate's/probationer's signature indicates the inmate refused to provide
a sample. In this case, inmate's/probationer's signature endorses refusal to provide a
sample. If the inmate/probationer refuses to sign, the staff member should sign in the
inmate's/probationer's box.
4. A copy of this form should be attached to any disciplinary report resulting from
refusing to provide a sample.|Col2|Col3|Col4|C
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S| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |(1) INMATE/PROBATIONER
STAFF INIT
NAME AND NUMBER
(2) SIGNATURE OF INMATE/
/PROBATIONER REF(?)|
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TIME|CONTAINER
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+/-||| |(1)
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(2)
______||||||||||||||| _________________________________ _________________ __________________________________________ _________________ STAFF IN CHARGE OF COLLECTION DATE & TIME RESULTS RECEIVED: DEP. WARDEN SECURITY/CHIEF OF SECURITY DATE & TIME Copies: Care and Treatment/Ass. Supt./Chief Counselor ________________________________ __________________ IF CONFIRMATION REQUIRED, FORM RETURNED TO PROJECT SUPERVISOR: STAFF IN CHARGE OF ANALYSIS DATE & TIME __________________________________ _____________________ STAFF IN CHARGE OF CONFIRMATION DATE & TIME SPECIMEN SENT FOR CONFIRMATION ``` RETENTION SCHEDULE: Attachment 1 of this SOP, when complete will be filed locally and kept for one year if the results are negative. If the results are positive, the form will become part of a disciplinary package that is placed in the inmate’s case history file. The case history file is kept according to the official records retention schedule. ```