01 I - Fwd: PSY ALERT INMATES: CHECK THE PP64 SCREENING FORM DAILY BEFORE RELEASING INMATES FROM R&D From: To: Psychdept Date: 8/7/2018 12:13 PM Subject: Fwd: PSY ALERT INMATES: CHECK THE PP64 SCREENING FORM DAILY BEFORE RELEASING INMATES FROM R&D Attachments: PSY ALERT INMATES: ALWAYS CHECK THE PP64 SCREENING FORM; -OTWI8II001Fi.pdf Psy.D. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center Office: Fax: E-mail: >.» 8/7/2018 12:06 PM > » SEE ATTACHED INSTRUCTIONS. PSY ALERT INMATES CANNOT BE RELEASED TO GP, SUICIDE WATCH, OR SHU UNTIL PSYCHOLOGY HAS ASSESSED THEM. EVEN IF IT IS AFTER HOURS, PSYCHOLOGY MUST BE NOTIFIED AND ARE REQUIRED TO COME IN AND INTERVIEW PSY ALERT INMATES PRIOR TO THEIR RELEASE TO GP. UNIT TEAM - should be reviewing the bottom of the PP64 for Psy Alert status as soon as they conduct the intake screening. Psychology should be notified IMMEDIATELY if an inmate is a PSY Alert. LIEUTENANTS- after hours (when no unit team available), should be reviewing the bottom of the PP64 for Psy Alert status as soon as they conduct the intake screening. Psychology should be notified IMMEDIATELY if an inmate is a PSY Alert. Psy.D. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center Office: Fax: E-mail: er2miller@bonstov file:///C/Users/BOP19019/AppData/Local/Temp/XPgrpwise/SDBABB96NYMDOMINY... 1/14/2020 EFTA00048737

NYMDH 535.08 • FEDERAL BUREAU OF PRISONS PAGE 001 • NAME • REGISTER NO: RACE / SEX.: RESIDENCE..: CABINES, UNIQUE 77001-054 BLACK / MALE BRONX, NY 10460 INTAKE SCREENING FORM UNIT DOB (AGE): ETHNIC...: RSP OF...: • 12-02 • 15:45 05-04-1980 (36 OTHER THAN HIS NYM A-PRE DATE 1) INMATE I NTERVIEW / TIME ARRIVED: TIME INTERVIEWED: DO YOU KNOW OF ANY REASON THAT YOU SHOULD NOT BE PLACED IN GENERAL POPULATION ? YES 2) HAVE YOU ASSISTED LAW ENFORCEMENT AGENTS IN ANY WAY YES 3) ARE YOU A CIM CASE ? YES 4) HAVE YOU TESTIFIED AGAINST ANYONE IN COURT YES 5) ARE YOU A MEMBER/ASSOCIATE OF ANY GANG ? YES 6A) HAVE YOU EVER BEEN SEXUALLY ASSAULTED ? YES 68) HAVE YOU RECENTLY BEEN SEXUALLY ASSAULTED ? YES INTERVIEWER COMMENTS: 2016 19 CIRCLE ONE: I HAVE / HAVE NOT RECEIVED A BUREAU OF PRISONS "ADMISSIONS AND ORIENTATION BOOKLET" DEFINING MY 'RIGHTS AND RESPONSIBILITIES' AND THE •PROHIBITED ACTS AND DISCIPLINARY SEVERITY SCALE'. DO YOU WISH TO SELF-IDENTIFY YOUR SEXUAL ORIENTATION, GENDER IDENTITY, ANY DISABILITIES, AND/OR SELF-PERCEPTION OF VULNERABILITY ? YES NO Ni INMATE COMMENT: A INMATE SIGNATURE: DATE: INTERVIEWER: TITLE: DATE: STAFF CHECKLIST PSI REVIEWED ? CENTRAL FILE REVIEWED ? IS THERE A HISTORY OF SEXUALLY AGGRESSIVE BEHAVIOR ? COMMENTS: YES YES YES 0 0 0 IF GENERAL PHYSICAL APPEARANCE IS NOT GOOD, EXPLAIN: PSYCH ALERT MO (IF YES, DO NOT RELEASE TO ENERAL POPULATION, NOTIFY PSYCHO • Y) OK FOR GENERAL POPULATION: YES NO tIF NO, EXPLAIN) EFTA00048738

NYMDH 535.08 • FRDRRAL BUREAU OF PRISONS PAGE 002 • :NTAKE SCREENING FORM • 12-02 2016 • 15:45 19 NAME CABINES, UNIQUE REGISTER NO: 77001-054 008 (AGE): 05.04-1980 (36 RACE / SEX.: BLACK / MALE ETHNIC...: OTHER THAN H:S RESIDENCR..: BRONX, NY 10460 RSP OF...: NYM A-PRE MCMT VAR...: PUB SAFETY.: SEVERITY...: PRIOR VOL SURR...: REVIEW DATE: ESCAPE • VIOLENCE...: CMG: MDS: NO DUTY OPFN/CHG RMKS NONE NONE MODERATE NONE NO 05.06-2016 NONE a 15 YRS SERIOUS DESTINATION..: USN LOCATION.: DESIG REQ BY.: DT DESIGNATED: USM-NYS PETS DSC 05.06-2016 LEVEL/CUSTODY: MEDIUM /IN PROJ REL DATE: PAW REL METH: TRANSFER DATE: 08-02.2016 TRANSFER TYPE: ADM CHANGE . NO P/S , NO PAPER , SUIC WATCH : 16CR.097(ALC),STUDY PURSUANT TO 18:4241C8)EXAM/EVAL NTE: ODAYS BASE OFFENSE:POSS WPN(FIREARM) CCM REMARKS..: D/RTJ.KEN EXAM/EVAL,BASE OFF:POSS WEAPON(FIREARM),PR:97' ETIT LARC,ROB,99'ASLT W/INJ.00'RES ARR,02'CS MARIJ,CP LOADED [REAR POSS CNTEND IN PRISON,NO TOED/MEN HX AVAIL, SUB ABUSE HX. •ASSAULT ON POLICE OFFICER W/FIREARM PRR 129" DES:G REMARKS: THIS IS A CRT ORD•D 42418 PSY STUDY. •NOTE• SENSIT:VR-LIMITED OFFICIAL USE CMC AND SEPARATEE HARDCOPY DATA ATTACHED EFTA00048739

NYMINI 535.08 • FEDERAL BUREAU OF PRISONS • 12-02 2016 PAGE 003 OP 003 • CIM CLEARANCE AND SEPARATSS DATA • 15:45 19 REGISTER NO: 77001-054 NAME: CABINES REGISTER FIRST ARS ARS ARS ARS NUMBER LAST NAME NAME FCL ASSIGN DATE TIME :Gil 77001-054 CABINES UNIQUE NYM A-PRE 11-30-2016 1029 H -001L 02 REMARKS: 5/6/16 OMDT/SMB; DSO TO SPG MH FOR CRT ORD'D 4241B PSY S7_V[jfY•• 02 REMARKS: •• REG DIR TRVL, USMS TO COORD TRVL/14 SPG. PO: EXEMPT P0011 THIS INMATE HAS NO CMC ASSIGNMENTS EFTA00048740

Bed Book Observation Schedule January — March 2020 Sunday Monday Tuesday Wednesday Thursday Friday Saturday January 1 7 South AW-0 January 2 Unit 2 AW-P January 3 11 South Executive Assistant January 4 5 North IDO January 5 Unit 2 IDO January 6 7 South Captain January 7 SHU Warden January 8 11 South AW-0 January 9 9 North AW-P January 10 5 South Executive Assistant January 11 11 North 100 January 12 9 North I00 January 13 S North Warden January 14 11 South AW-0 January 15 Unit 2 AW-P January 16 7 South Executive Assistant January 17 SHU Captain January 18 S South IDO January 19 5 North 100 January 20 Unit 2 AW-0 January 21 S South AW-P January 22 7 North Executive Assistant January 23 SHU Warden January 24 7 North Captain January 25 9 North IDO January 26 7 South IDO January 27 11 North Warden January 28 11 South Captain January 29 SHU AW-P January 30 7 North Executive Assistant January 31 5 South AW-0 February 1 S North 100 February 2 Unit 2 IDO February 3 7 South Captain February 4 SHU Warden February 5 11 South AW-0 February 6 9 North AW-P February 7 S South Executive Assistant February 8 11 North IDO February 9 9 North IDO February 10 5 North Warden February 11 11 South AW-0 February 12 Unit 2 AW-P February 13 7 South Executive Assistant February 14 SHU Captain February 15 5 South 100 February 16 S North IDO February 17 Unit 2 AW-0 February 18 S South AW-P February 19 7 North Executive Assistant February 20 SHU Captain February 21 7 North Warden February 22 9 North IDO February 23 7 South 100 February 24 11 North Warden February 25 11 South Captain February 26 SHU AW-P February 27 7 North Executive Assistant February 28 5 South AW-0 February 29 S North IDO March 1 7 South IDO March 2 Unit 2 AW-P March 3 11 South Executive Assistant March 4 S North AW-0 March 5 Unit 2 Warden March 6 7 South Captain March 7 SHU IDO March 8 11 South IDO March 9 9 North AW-P March 10 5 South AW-0 March 11 11 North Captain March 12 SHU Executive Assistant March 13 S North Warden March 14 11 South 100 March 15 Unit 2 IDO March 16 7 South Executive Assistant March 17 SHU Captain March 18 5 South Warden March 19 5 North AW-P March 20 Unit 2 AW-0 March 21 5 South IDO March 22 7 North 100 March 23 SHU Captain March 24 7 North Warden March 2S 9 North AW-0 Mardi 26 7 South AW-P March 27 11 North Executive Assistant March 28 11 South IDO Mardi 29 Unit 2 IDO March 30 7 North Executive Assistant March 31 S South AW-0 EFTA00048741

Bed Book Observation Schedule April - June 2020 Sunday Monday Tuesday Wednesday 1 Thursday Friday Saturday April 1 7 South AW-0 April 2 Unit 2 AW-P April 3 11 South Executive Assistant April 4 SHU IDO April 5 Unit 2 IDO April 6 7 South Captain Aprll 7 SHU Warden April 8 11 South AW-0 April 9 9 North AW-P April 10 5 South Executive Assistant April 11 11 North IDO April 12 9 North 100 April 13 S North Warden April 14 11 South AW-0 April 15 Unit 2 AW-P April 16 7 South Executive Assistant April 17 SHU Captain April 18 5 South IDO April 19 S North IDO April 20 Unit 2 AW-0 April 21 S South AW-P April 22 7 North Executive Assistant April 23 SHU Warden April 24 7 North Captain April 25 9 North IDO April 26 7 South 100 April 27 11 North Warden April 28 11 South Captain April 29 SHU AW-P April 30 7 North Executive Assistant May 1 5 South AW-0 May 2 S North IDO May 3 Unit 2 IDO May 4 7 South Captain May 5 SHU Warden May 6 11 South AW-0 May 7 9 North AW-P May 8 S South Executive Assistant May 9 11 North 100 May 10 9 North 100 May 11 5 North Warden May 12 11 South AW-0 May 13 Unit 2 AW-P May 14 7 South Executive Assistant May 15 SHU Captain May 16 5 South 100 May 17 S North IDO May 18 Unit 2 AW-0 May 19 5 South AW-P May 20 7 North Executive Assistant May 21 SHU Captain May 22 7 North Warden May 23 9 North 100 May 24 7 South 100 May 25 11 North Warden May 26 11 South Captain May 27 SHU AW-P June 3 5 North AW-0 May 28 7 North Executive Assistant May 29 S South AW-0 May 30 5 North IDO s- • May 31 7 South IDO I— June 1 — 7 — Unit 2 AW-P June 2. 11 South Executive Assistant June 4 Unit 2 Warden June 5 7 South C!ptain June 6 SHU IDO June 7 11 South IDO June 8 9 North AW-P June 9 5 South AW-0 lune 10 11 North Captain June 11 SHU Executive Assistant June 12 S North Warden June 13 11 South IDO June 14 Unit 2 IDO June 15 7 South Executive Assistant June 16 SHU Captain June 17 5 South Warden June 18 5 North AW-P June 19 Unit 2 AW-0 June 20 5 South IDO June 21 7 North 100 June 22 SHU Captain lune 23 7 North Warden June 24 9 North AW-0 June 25 7 South AW-P June 26 11 North Executive Assistant June 27 11 South IDO June 28 Unit 2 100 June 29 7 North Executive Assistant June 30 5 South AW-0 _ _. EFTA00048742

Bed Book Observation Schedule July — September 2020 Unit 2 IDO July 12 9 North IDO July 19 5 North 100 Ju 7 August Unit 2 IDO ' August 9 9 North IDO August 16 S North IDO August 23 7 South September 6 11 South IDO September 13 Unit 2 IDO September 20 7 North IDO September 27 Unit 2 IDO Monday 11 Warden August 3 7 South Captain August 10 5 North Warden August 17 Unit 2 AW-0 August 24 11 North September 7 9 North AW-P September 14 7 South Executive Assistant September 21 SHU Captain September 28 7 North Executive Assistant July 7 SHU Warden July 14 11 South AW-0 July 21 S South AW-P July 28 11 South Captain August 4 SHU Warden August 11 11 South AW-0 August 18 5 South AW-P August 25 11 South 11 South AW-0 August 12 Unit 2 AW-P August 19 AW-P July 9 North AW-P SHU Warden July 30 7 North Executive Ass August 6 9 North AW-P August 13 7 South Executive Assistant August 20 SHU Captain August 27 7 North September 1 11 South Executive Assistant September 8 S South AW-O September 15 SHU Captain September 22 7 North Warden September 29 S South AW-0 September 2 September 3 5 North Unit 2 AW-0 Warden September 9 September 10 11 North SHU Captain Executive Assistant September 16 5 South Warden September 23 9 North AW-0 September 30 SHU AW-P September 17 North AW-P September 24 7 South AW-P September 4 7 South Captain September 5 SHU IDO Executive Assistant July 10 5 South Executive Assistant August 5 South Executive Assistant September 11 5 North Warden September 18 Unit 2 AW-0 IDO July 11 11 North IDO July 18 5 South IDO July 25 9 North 100 August 1 S North IDO August 8 11 North 100 September 12 11 South IDO September 19 S South IDO September 26 11 South IDO September 25 11 North Executive Assistant EFTA00048743