Suicide Watch
Chronological
Log
Inmate Companions Log
Name of inmate on watch:
ONLY ITEMS ALLOWED:
Suicide Mattress
Institution:
Date Watch Began / Ended
To be completed by Chief Psychologist at conclusion of watch:
Booklet of
SWCL - INMATE
EFTA00035257
STAPLE LOCAL PROCEDURES HERE
Check one of the following:
h.
❑ This is the initial log book for this suicide watc
Enter date and time watch began:
h.
This is a continuation log book for this watc
ted:
Enter date and time this watch book was initia
Instructions to Observer:
minutes.
Document your observations every
of your shift.
Legibly print and sign your name at the beginning
EFTA00035258
Suicide Watch Observation Log
I„
Name of inmate —
on watch:
„.,
4JY -it i ( 1 Reg a: Date: —1 23 e
Time Observations: Briefly note your observations. Initial all entries. Initials
'yr7Mv ‘'141- 65tubn 40 eel I 'P[.(
M S re(4 1/1It I. &E
1 Lis A b‘ 0kt ge-a
2. akm % I Ar 2 J i r l ie.i.
2 lb, fr.,scs k,S me (( k 'lrii..I 4 ic (l
cll.
2 3s im SW) 6{i -Irti iw h r? y, 4.4
(AAA 4 f
2 434 t •lik ov ;3 F i3
Avi t W Ci N u. 15e
IC
4-4 kw!). fie Itird
3'36,«• 4 Si K. n 6( 0
irp4
/
LIc6 SM-1- v on a
k
) it; 0 S: -liAte)QA -;e1
Si-kiliNi.aU. 44— fir -41-( kV
:qc knU,\.•1 -)4,1 1477 -4-kk.
( cumpi S 4 44 (a
L5121 _1i v .0 - OCef
r grim- w C i ,k,
c 5 Am M 3
C-4-14,I 04r
Note to all observers: Legibly print gnd sign your name at the beginning of your shift.
EFTA00035259
Suicide Watch
Chronological
Log
Staff Suicide Watch
Observers Only
Name of inmate on watch:
Ep54-elin. J.
Register #:
Institution:
MOT', New \leyK
Date Watch Began / Ended
July 23,'2.01C1 J-v)/ iq
To be completed by Chief Psychologist at conclusion of watch:
Booklet of
SWCL - STAFF
EFTA00035260
STAPLE LOCAL PROCEDURES HERE
Check one of the following:
This is the initial log book for this suicide watch.
Enter date and time watch began:
July 23)20in a+ ( .MOAN
This a continuation log book for this watch.
. . „
Eriter date and time this watch book was
Instructions to Observer:
Document your observations every )5 minutes.
Legibly print and sign your name at the beginning of your shift.
EFTA00035261
E.p,54e-in Suicide Watch Observation Log
Nam of Inmate
on watch: Reg #: Date: 1123 icl
Time Observations: Briefly note your observations. Initial all entries. Initials
4 0'M 1 leAt Or.....- •h. to .. 'a' ea -44
I '.145Akqi inrndfe 1\fin on bed
2'.00Am Inmai-e , i+i-in(1 on IDPd +01King
2 . i5A ,/i )nrn -l-e ,...*+eo-his Ceilniol-e. 1-rieA +O Val h.
2. 3oAm tnrnal-e. 3i-\-i-ins on lca-\ -i-ti cnio remember
vil-ni- hopptne54
2'..45Am InmC14e Si-i-1-1(-5 on Iced
3..c) , - . .,ii.1 on hed
3'. i 5A0 IIMIIIIIIIIIIIIIIII -4-6Aves i c.4-ure...5 a i rynlie.
5.30Am inrime.. 6+4-iro on bed
5'.45Am Inn- +e. 6i+-hn3 on bed
-42.0044 Incra4-e. ,...5C4-ting On 1-rd
4', ISAM Inmni-e. Lli-t-lin9 Dn bed
4 .30A" Inerai-e. Sinrdin3 cti- dcor 40Mcg
4-45AM I nriY)-1-e. Okla-lir-9 CI} door -1-a116(9
5*. COAm 1nrno -1-e 61--Fin on bed
5:15Am I nmale olarril a4- door
5.,3C)Am nrnak (5-Itincjino 01 door s
5‘,45ANI Inmate c5kinr}ing a+ door
(x).•DONA IntyMe .-5--bnJino OA- door
co'. I.sm.., inm;:ile. ,.540 1i(-)9 ai- door
to:•,3oAm Inrcrale. akinStro (1-1- dory/-
V.45AM morale. Olan6in9 al- dnnr
4'.D0Alvi Inmai-e- (NtAn6in9 al- Om'
Note to all observers: Legibly print and sign your name at the beginning of your shift.
1
EFTA00035262