SOP_NUMBER: 209.11-att-9
TITLE: Restrictive Housing Assignment - Juvenile Offender Administrative Segregation: Checklist (RHA-JOAS Checklist)
DIVISION: Facilities
TOPIC_AREA: 209 Policy-Facilities Control/Discipline/Segregation
EFFECTIVE_DATE: 2016-04-11
WORD_COUNT: 214
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105986
URL: https://gps.press/sop-data/209.11-att-9/

SUMMARY:
This is a daily monitoring and documentation checklist used by GDC staff to track juvenile offenders placed in restrictive housing/administrative segregation. The form records meal service, shower access, exercise time, cell sanitation, medical visits, and general conduct observations for each shift during the offender's segregation assignment. It requires administrative review and officer signatures and must be retained in the offender's case history file upon completion.

KEY_TOPICS: restrictive housing, administrative segregation, juvenile offenders, JOAS, segregation checklist, daily monitoring, meal service, exercise time, shower access, cell sanitation, conduct documentation, administrative review, GDC number tracking

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 9**
**WARDEN/DESIGNEE'S REVIEW** **SOP 209.11**
**AFTER DISCHARGE (SIGN :) ________________________** **(04/11/16)**
**Page 1**
**RESTRICTIVE HOUSING ASSIGNMENT - JUVENILE OFFENDER ADMINISTRATIVE SEGREGATION: CHECKLIST**

**OFFENDER’S NAME: ___________________________________________GDC NUMBER:__________________ RACE: __________**
**PRIOR LIVING UNIT: __________ COUNSELOR: ______________________________**
**DATE COMMITTED: __________________ EXPECTED DISCHARGE DATE: _____________________**
**TIME COMMITTED: ____________ ACTUAL DISCHARGE DATE & TIME: ________________________________________**
**REASON FOR ASSIGNMENT: ________________________________________________________________________________**
**PERTINENT INFORMATION_________________________________________________________________________________**


**STATUS CHANGE**

**DATE COMMITTED: _________________EXPECTED DISCHARGE DATE_____________________STATUS___________**
**TIME COMMITTED__________________ACTUAL DISCHARGE DATE &TIME___________________________**
**___________________________________________________________________________________________________________**

**PERTINENT INFORMATION: ____________________________________________________________________**



















|Date|Shift|Meals|Col4|Col5|SH|EXER|CELL<br>SANT|COMMENTS<br>(Include note/sig. of staff<br>visits, such as medical)|ADM<br>REV:|OFFICER<br>SIG:|
|---|---|---|---|---|---|---|---|---|---|---|
|<br> <br>**Date**<br>|<br> <br>**Shift**<br>|**B **|**L **|**S **|**S **|**S **|**S **|**S **|**S **|**S **|
|<br>**MON.**|**1st**||||||||||
|<br>**MON.**|**2nd**||||||||||
|<br>**TUES.**|**1st**||||||||||
|<br>**TUES.**|**2nd**||||||||||
|<br>**WED.**|**1st**||||||||||
|<br>**WED.**|**2nd**||||||||||
|<br>**THURS.**|**1st**||||||||||
|<br>**THURS.**|**2nd**||||||||||
|<br>**FRI.**|**1st**||||||||||
|<br>**FRI.**|**2nd**||||||||||
|<br>**SAT.**|**1st**||||||||||
|<br>**SAT.**|**2nd**||||||||||
|<br>**SUN.**|**1st**||||||||||
|<br>**SUN.**|**2nd**||||||||||


**EXPLANATORY NOTES: Meals - Yes(Y) or No(N) or Refused(R); Shower(SH) - Same codes as meals; Exercise (Exer) - Enter actual time period (e.g. 9:15AM -**
**10:30AM Inside)**
**PERTINENT INFORMATION: Epileptic, Diabetic, Religious Diet, Suicidal, Assaultive, etc.**
**COMMENTS: General conduct, attitude, hygiene, sanitation of cell (continue on back if needed).**
**ADMINISTRATIVE REVIEW: Deputy Warden or Duty Officer, Shift OIC/Captain, as appropriate**

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