SOP 209.11-att-10: RHA-JOAS Checklist - 30-Minute and 15-Minute Watch Form_Observation Record

Length:
112 words

Full Text

Attachment 10

SOP 209.11

(04/11/16)

JUVENILE OFFENDER’s NAME: ______________

GDC#:________________RESTRICTIVE HOUSING ASSIGNMENT-JUVENILE OFFENDER ADMINISTRATIVE SEGREGATION: CHECKLIST
30-MINUTE OR 15-MINUTE WATCH FORM/OBSERVATION RECORD

|DATE|Col2|DATE|Col4|DATE|Col6|DATE|Col8|DATE|Col10|DATE|Col12|DATE|Col14|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|MONDAY|MONDAY|TUESDAY|TUESDAY|WEDNESDAY|WEDNESDAY|THRUSDAY|THRUSDAY|FRIDAY|FRIDAY|SATURDAY|SATURDAY|SUNDAY|SUNDAY|
|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
TIME/INITIALS|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|
|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|__:__|

Attachment 10

SOP 209.11

(04/11/16)

RETENTION SCHEDULE: Upon completion of this form, it shall be placed in the juvenile offender’s case history file.

Attachments (11)

  1. RHA-JOAS Program Assignment Recommendation and 1, RHA-JOAS Program Initial Segregation Review (472 words)
  2. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Assignment Memo (141 words)
  3. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Assignment Appeal Form (169 words)
  4. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation Program Handout (1,163 words)
  5. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation 30 Day Review (171 words)
  6. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation 30 Day Review Memo (127 words)
  7. RHA-JOAS Program 30 Day Review_Assignment Appeal Form (183 words)
  8. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Cell Check Sheet (147 words)
  9. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation: Checklist (RHA-JOAS Checklist) (214 words)
  10. RHA-JOAS Checklist - 30-Minute and 15-Minute Watch Form_Observation Record (112 words)
  11. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation Performance Recording Sheet (42 words)
Machine-readable: JSON Plain Text