EFTA00110502.pdf

Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Lp 5 -c Register #: li4 9°Ol l- G54 Institution: Date Watch Began / Ended ONLY ITEMS ALLOWED: E 2 9-) CU "O as :O eri V) V) V) To be completed by Chief Psychologist at conclusion of watch: Booklet of Suicide Mattress SWCL - INMATE EFTA00110502 STAPLE LOCAL PROCEDURES HERE Check one of the following: 0 This is the initial log book for this suicide watch. Enter date and time watch began: 0 This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. EFTA00110503 Suicide Watch Observation Log Name of inmate — 1 „ „._ on watch: 4JY -it i ( 1 Reg Si: 143 10• .5q Date: -1 23e Time Observations: Briefly note your observations. Initial all entries. Initials j:Lj0 M &"4 5k+ ,,,,,..„ 40 sin it i (SE re i I VI( l • LIS" ,A% I ,►tq Oki gfa 2. ainvi % I 2 k+ fr. . i , me(( k ei • J i i 5 (4[1( (4 i 2 5 es im S Wilt (o? i -het, ,w h (-Cu -44 uvk a 4 1, 2' 4 34 ( g Ait 'W 43 Avi C Ni 6e 13 3. 1 1 4-4 kw!). fie hurl 3:56 Av, c i I-A; n 6( 0 3' /isi 4 g Oil F-e3 LIc6 / c - r-F- v on a 710 S: QA , liAle) 7d-e S ' -n A. 44— .&Alr4=i-kk 41--( kV ) cktit\.#1 tyl 14,./ to invi S 4 "14 ta 1-5 — cite* 0 — O C e f r ett A' c liC A M 64 >)%-k- A " c \--h-IA i s Oetni Note to all observers: Legibly print sign your name at the beginning of your shift. 1 EFTA00110504 Suicide Watch Chronological Log Staff Suicide Watch Observers Only Name of inmate on watch: Ep54-e".4"). J. Register #: 1. Co Sta-ma y Institution: MOT', New \leo< Date Watch Began / Ended July 23,2014 J-v)/ iq To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - STAFF EFTA00110505 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. EFTA00110506 E-47,54e_in Suicide Watch Observation Log Nam d of Inmate on watch: Reg #: --q (1)3 lb - 054 Date: 1 23 Ici Time Observations: Briefly note your observations. Initial all entries. Initials V.4DAM 1 nmet-e. lovot hl- clwin ft) Su ir iCie 06 I-44- I 1-15Akqi Inrndfe lyin on her( 2.,0DAm Inmai-e , i-4-1-in(1 On IDP(1 +0 I king 2 . I5Aivi I nr -l-e.L.Stict+eohi 5 Ceilnio4-e. --tired +0 val h' 2..30Am I nrrOk 5i +i-rocs on bad -hi ii'n -F0 remember vgl-ni- happtnert 2...4"54,4 Inmci+e ai-H-ir9 on Iced 3..CDAm In on fed 3 . i5A0 Li-. i.(&_s pi CA-Ure..5 o f rynfl 5.30Am Inrillie. oi+-1-iryi on beri 5',46Am Inmo+e. 6i-1--h on be6 42. CO44 I n cm1 ,...51.4--ting On }-Pd 4., ISAM I ninc3-4-e. LIi-1-I-1 n5 on bed 4"..3oAm nerai-e. ,51{1r6 n3 cti- door -1-alkir9 4-45Am It-vino-le. Q5-.}orrii a+ door -1-alkie-9 5*. LOAM I nrnO -e 6 i -I-41 no on 1X-C1 5:15Am Inmo4e_ olard a+ door 5.,3DAm 7 nrnal-e, 6-IT-1 In° 0-4 door 5.,45ANI 4. Innla-le cskirylino 6-l- door ,- (x)•.DOPktvi Intnn-te. —1-lartlino 0.4- dicer Co'. I5 A i,, inrral-e- ,..51/1r- Iirt) a}- door 40:30Am Inryyai-e. aktnclico cii- deo/ li.45Am Ininalt. OlQn6i cii- (k)nr 4 .. al) ANA In mC41-e- (NtAn6 i n9 co- Om' Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110507