SOP 508.28-att-3: Observation Cell Log

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SOP 508.28
Attachment 3

8/12/19

OBSERVATION CELL LOG
(used only to temporarily keep the offender safe until other arrangements can be made)

|Offender’s Name|GDC ID #|Date/Time of
Placement|Col4|Date/time of
Release
(not to exceed 24
hours)|Col6|Comments (do not leave blank)
(reason for placement in isolation/segregation cell; reason
placement exceeded 24 hours; reason offender was not
removed; final disposition etc.)|
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Form no. M68-01-03

Retention Schedule: Upon completion, this form shall be maintained in the mental health area for 10 years.

Attachments (6)

  1. Certificate of Approval for Crisis Stabilization Unit (CSU), Acute Care Unit (ACU), and Observation Cells (70 words)
  2. Offender Critical Incident Notification Form (174 words)
  3. Observation Cell Log (86 words)
  4. Suicide/Self-Injurious/Assaultive Behavior Information Form (274 words)
  5. Observation Cell Notification (Form M68-01-05) (72 words)
  6. Cell Analysis Form (M68-01-10) (845 words)
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