Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Institution: Date Watch Began / Ended ONLY ITEMS ALLOWED: To be completed by Chief Psychologist at conclusion of watch: Booklet of Suicide Mattress SWCL - INMATE EFTA00035257

STAPLE LOCAL PROCEDURES HERE Check one of the following: K This is the initial log book for this suicide watch. Enter date and time watch began: 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. EFTA00035258

Suicide Watch Observation Log Name of inmate — I „ on watch: 4JY -it i ( „., 1 Reg a: Date: —1 23 e Time Observations: Briefly note your observations. Initial all entries. Initials 'yr7Mv M S re( ‘' 4 141- 65tubn 40 1/1 It I. &E eel I 'P[.( 'P[.( 1 Lis A b‘ 0 kt 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 3 s 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 C i N u. 15e IC 4-4 kw!). fie Itird 3'36,«• 4 Si K. n 6( 0 irp4 LIc6 k / SM-1- v on a it; S: QA -liAte) -;e1 0 Si-kiliNi.aU. 44— fir -41-( kV :qc ) knU,\.•1 -)4,1 1477 -4-kk. ( cumpi S 4 44 (a L5121 _ 1 i v .0 - OC ef r grim- w C i ,k, c 5 Am M 3C-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 1 nrno -1-e 61--Fin on bed 5:15Am I n male olarril a4- door 5.,3C)Am nrnak (5-Itincji no 01 door 5‘,45ANI s 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