SOP_NUMBER: 209.11-att-3
TITLE: Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Assignment Appeal Form
DIVISION: Facilities
TOPIC_AREA: 209 Policy-Facilities Control/Discipline/Segregation
EFFECTIVE_DATE: 2016-04-11
WORD_COUNT: 169
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105980
URL: https://gps.press/sop-data/209.11-att-3/

SUMMARY:
This form allows juvenile offenders in the Georgia Department of Corrections to appeal their placement in Restrictive Housing Assignment – Juvenile Offender Administrative Segregation (RHA-JOAS). Juvenile offenders have three business days to submit a written rebuttal explaining why they believe the restrictive housing assignment was inappropriate. The Director of Field Operations or designee reviews the appeal and makes a final determination on whether to uphold or overturn the assignment.

KEY_TOPICS: juvenile offender appeal, restrictive housing appeal, administrative segregation appeal, RHA-JOAS, solitary confinement, segregation assignment, appeal form, appeal process, rebuttal, juvenile discipline

ATTACHMENTS:
  1. RHA-JOAS Program Assignment Recommendation and 1, RHA-JOAS Program Initial Segregation Review
     URL: https://gps.press/sop-data/209.11-att-1/
  2. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Assignment Memo
     URL: https://gps.press/sop-data/209.11-att-2/
  3. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Assignment Appeal Form
     URL: https://gps.press/sop-data/209.11-att-3/
  4. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation Program Handout
     URL: https://gps.press/sop-data/209.11-att-4/
  5. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation 30 Day Review
     URL: https://gps.press/sop-data/209.11-att-5/
  6. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation 30 Day Review Memo
     URL: https://gps.press/sop-data/209.11-att-6/
  7. RHA-JOAS Program 30 Day Review_Assignment Appeal Form
     URL: https://gps.press/sop-data/209.11-att-7/
  8. Restrictive Housing Assignment – Juvenile Offender Administrative Segregation Cell Check Sheet
     URL: https://gps.press/sop-data/209.11-att-8/
  9. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation: Checklist (RHA-JOAS Checklist)
     URL: https://gps.press/sop-data/209.11-att-9/
  10. RHA-JOAS Checklist - 30-Minute and 15-Minute Watch Form_Observation Record
     URL: https://gps.press/sop-data/209.11-att-10/
  11. Restrictive Housing Assignment - Juvenile Offender Administrative Segregation Performance Recording Sheet
     URL: https://gps.press/sop-data/209.11-att-11/

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FULL TEXT:
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**Attachment 3**

**SOP 209.11**
**(04/11/16)**


**Restrictive Housing Assignment – Juvenile Offender Administrative Segregation**

**Assignment Appeal Form**

**I.** **Juvenile offender:__________________________ GDC #:________________DATE:____________**

**II.    Restrictive Housing Assignment – Juvenile Offender Administrative Segregation**
**Assignment**


**In accordance with GDC SOP, you were placed in the Restrictive Housing Assignment – Juvenile Offender**
**Administrative Segregation for the following reasons:**
**_______________________________________________________________________________**

**_______________________________________________________________________________**

**III.** **Juvenile offender's rebuttal: (within 3 business days submit to the assigned counselor who will forward to the**
**Director of Field Operations Office).**
**_______________________________________________________________________________**

**_______________________________________________________________________________**

**_______________________________________________________________________________**

**_______________________________________________________________________________**

**DATE APPEAL RECEIVED: ___________________________ BY:_______________________________________(COUNSELOR)**

**IV.** **Review of Appeal**

**_____I** **concur /** **disagree with the Restrictive Housing Assignment – Juvenile Offender Administrative**
**Segregation Classification Committee / Warden’s Action. The following decision(s) has/have been made in this case.**

**___________________________________________________________________________________**

**_________________________________________________________________________________**

**__________________________________________** **_______________________**
**Director of Field Operations / Designee’s Signature**
**Date**

**Copies:** **Offender**
**-------------------------------------------------------------------------------------------------------------------------------------**
**JUVENILE OFFENDER RECEIPT FOR** **RESTRICTIVE HOUSING ASSIGNMENT – JUVENILE OFFENDER**
**ADMINISTRATIVE SEGREGATION ASSIGNMENT**


**Juvenile Offender’s Name: ______________________________________ I.D. #: ______________________**

**I acknowledge receipt of this appeal from the above juvenile offender.**

**Date: ___/___/____** **Counselor’s Signature: ____________________________**


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