SOP 508.20-att-1: Restrictive Housing Rounds Log

Division:
Mental Health Services
Effective Date:
August 2, 2022
Reference Code:
VG40-0001
Topic Area:
508 Policy-MH Administration/Staff/Certification
PowerDMS:
View on PowerDMS
Length:
84 words

Summary

This form documents mental health staff rounds conducted in restrictive housing units. Mental health personnel use this log to record which offenders in restrictive housing require mental health services during their rounds, including the unit, date, time, and staff involved. The completed form must be retained in the mental health area for up to three years.

Key Topics

  • restrictive housing
  • mental health rounds
  • mental health services
  • segregation
  • restrictive housing log
  • offender mental health monitoring
  • mental health documentation
  • rounds documentation
  • Form M40-01-01
  • mental health staff

Full Text

SOP 508.20
Attachment 1

8/2/22

# Georgia Department of Corrections Mental Health Services Restrictive Housing Rounds Log

Restrictive Housing Unit: _____________________________________ Date: _________________________

Staff Person Conducting Rounds: _______________________________ Time In: ______________________

Officer(s) on Duty: ___________________________________________ Time Out: _____________________

Offenders in Need of Mental Health Services:

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________________________________________________ ____________________________________
Signature/Title of Mental Health Staff Person Mental Health Unit Manager Signature

Form no. M40-01-01 Page 1 of _____

Retention Schedule: Upon completion, this form shall be maintained in the mental health area until replaced or obsolete, and up to three (3) years.

Attachments (3)

  1. Restrictive Housing Rounds Log (84 words)
  2. Restrictive Housing Rounds - 48 Hour / Weekly Progress Note (184 words)
  3. Restrictive Housing Rounds - 30/90 Day Progress Note (180 words)
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