EFTA00110502.pdf

Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: ONLY ITEMS ALLOWED: Lp 5 -c Register #: li4 9°Ol l- G54 Suicide Mattress Institution: E CU as 2 "O :O Date Watch Began / Ended eri 9-) V) V) V) To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - INMATE EFTA00110502 STAPLE LOCAL PROCEDURES HERE Check one of the following: h. 0 This is the initial log book for this suicide watc 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: minutes. Document your observations every of your shift. Legibly print and sign your name at the beginning EFTA00110503  Suicide Watch Observation Log Name of inmate — on watch: 1„ „._ 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 rei I VI( l • LIS" ,A% I ,►tq Oki gfa 2. ainvi % I 2 k+ fr.. i , me(( k ei • J i i5 (4 [1 ( (4 i 2 5 es im S Wilt (o? i -het, ,w h (-Cu-44 uvk a 4 1, 4 34 2' ( Ait 'W g 43 Avi C Ni 6e 13 3. 1 1 4-4 kw!). fie hurl 3:56Av, /isi c i I-A; n 6( 0 3' 4 g Oil F-e3 LIc6 / a c - r-F- v on 710 S:, liAle)QA 7d-e S ' -n A. 44— .&Alr 4=i-kk41--( kV cktit\.#1 tyl 14,./ to ) invi S 4 "14 ta — cite* 0 — O Ce f 1-5 r ett A' c liC AM 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 Namd 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 1nmet-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 +0Iking 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 In cm1 ,...51.4--ting On }-Pd 4., ISAM I ninc3-4-e. LIi-1-I-1n5 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 6i-I-41no on 1X-C1 5:15Am Inmo4e_ olard 7 a+ door 5..,3DAm nrnal-e, 6-IT-1 In° 0-4 door 5.,45ANI Innla-le cskirylino 6-l- door ,-4. (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- (NtAn6in9 co- Om' Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110507