7? - 7321(1) l1 (NF . Ontario Name (Last, First. Middle) . Segregation Decision/Reuiew $03840 Institution i gate 3 ClienM entl?ton Nos I Reasonls) for Segregation . - . . Date of Segregation E'Proiective Custody institution Security Medical InmateRequest 06/24/14 3E Inmate adVised 0F reason for Segregation Emmett: advised of opportunity to make oral or written submissions y?lnmete advised of gpportuntiy for interview with Superintendent inmate waives oppo?W?it?ow with Superintendent Name of SuperintendentlDesignate (Print) I tenw Date 'TsuSheil . A ignature of Superintendent Desisron (This section must be completed Within 5 days of the inmate's place nt? segregation) Inmate Submission . - . - Inmate continues to request to remain in segregation. SUperintendent Decision Release from Segregation F14 Continue Segregation Reasons: - - inmate has a long past history of refusing to be placed in a living unit. Currently being housed in Segregation-due to serious threats against a Correctional Of?cer. denUngnaie T. Sheii Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted mgr}! 30 days} inmate Submission inmate refuses to go to a living unit and is currently housed in segregation. Date 05l30/2014 Name of SuperintendenUDosignete(Print) Signature of SUperintendent Decision El? Release from Segregation Continue Segregation Reasons: I . . inmate has a long past history of refusing to be placed in a ?wing unit. Currently being housed in segregation due to serious threats against a Correctional Of?cer i Name of SuperintendentlDesignate (Print) - Signet Date Sheii 07/06/2014 . Supplementary Report for each Subsequent 30 Day Perlo_diuse reverse afform foraddt?ionalcommenfs) Comments Superintendent/Designate Si re Date . - MM/ddiywy 30 days. inmate submitted in writing to remain in I segregation due to nature of charges. Approved to contibue 07!24l2014 on own request. 60 days. Inmate refused written submission but verbalized he can?t go anywehere else. Has been criminally charged 0812212014 for threatening an of?cer while in custody. Approved to - nn?rinr I: nutritional-inn - oso 075-100 (10104) 000001 I Page 2 Regional Director Review Continued Segregation I Supported 0' El Not Supported Comments b?i. Verge?l. 3e: oqurJ/MTO. if. Name of Regional Director/Designate (Print) ,1 Signature of Regional DIrectorIDesignate Date @mc I 09/074101? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments I Slgnature Date Continued/Additional Comments by Superintendent/Designate Comments Slgnature Date Continued/Additional Comments by Regional Director/Designate Comments Signature Date I Dlatrlbulion: Dnalnal - Regional Dlreolar (Only for Regional Director Review) Copy - lnmale Flle CSD 075-100 (10l04) 000002 sap);- I g?Ontario - DETENTION CENTRE IINMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:_ OTIS Number:_ Inmate written submission for 30 day segregation review: s.21(1) Inmate Oral Submission for 30. day' Segregation Review: - (To be completed by Sergeant) \vv 30-0?45? - 5 m, - Inmate Date: Ila Witness Name: Witness Signature: 000003 a . . - . - MINISW 01? Segregation Decision] Review 0 and - . ntarto .Anst?it Ion i? Qunnte Detention Centre I Name (Last. First. Middle) Client identi?cation No. - Reasonis) for Segregation - Date of Segregation Protective Custody Institution Security Medical inmate Requiem 08/29/2014 inmate advised of reason for segregation inmate advised of opportunity to oral or written submissions IX inmate advised of opportuntiy for interview with Superintendent inmate waives ggpequr?yml?jew with Sggeriniendent Date Name ofSuperintendent/Designate (Print)_ I Signature of ent/ esign T. Shell - 08/29/2014 I Sugerintendent Decision (T his/section must be compieied within 5'days of the inmate's piece eni in segregation) Inmate Submission . - inmate very uncooperative and refuses to be placed anywhere other than segregation. Refuses to speak when asked about alternative placement and only requests his canteen. . Superintendent Decision Release from Segregation i2] Continue Segregation Reasons: Not Suitable or'cooperative for other placement. Name ofSuperintendent/Designate (Print) Signature of in t/Desl a Date . T. Shell a . My 09/01/2014- Segregation Review (inmate?s segregation is be reviewed every 5 days. Interview with inmate to begonduciad every 30 days) Inmate Submission - inmate very uncooperative and refuses to be placed anywhere other than segregation. Refuses to speak when asked about alternative placement. Superintendent Decision Ci Release from Segregation I i3) Continue Segregation Reasons: . Notsuitable or cooperative for other placement .- Name ofSuperintendent/Designate (Print) . Signatureo nt ent/D ignate Date - T. Shell 09/07/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) i Comments Superintendent/Designate Sign Date 30 days. inmate said he will not submit a written statement but states he is staying where he is. Due to history of 09/29/2014 refusal to be placed in'a living unit segregation to? continue. s.21(1) cso 075-100 (10/04) 000004 s.NlR ,7 Pagez Re?ne! Director Review Continued Segregation a? Supponed Not Supporied Comments ooL M. IT 3mg 36W . Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date ?g?a??gaw??E I [O/Or/Ziolcf Suggementagy Report for each Subsequent 30 Day Period (use bottom of Mn for additions! comments Comments SignatUre Date Continued/Additional Comments by Superintendent/Designate Comments . Signature Date 5.21 (1 Continued/Additional Comments lgLRegionai Director/Designate Comments Signature . Date - - Distribution: onainal - Rngiunnl Director {Only for Regional Dimcior Rewaw} Copy - inmrua Fire cso 075-100 (10/04) 000005 a BS an E1 siUR . ii? Ontario QUINTE INMATE SUBMISSION FOR 30 DAY SEGREGATION REVIEWS Inmate Name: OTIS Number Inmate written submission for 30 day segregation review; . Inmate declines maki a written statement. Inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeantf Inmate states he is staying where he is. Inmate has a history of segregation - placement. He becomes irritable when movement to a living unit is discussed and appears to function better on his own. Inmate Signature: 4145 Date: September 29/14 Witness Name: T. Sheil I 521(1), ?000006 Ministry of Community Safety and Correctional Services -. s.21(1) . Segregation" Decision/Revrew HO Sweet or . n) Ontario D. teaser l'Nama (Last. First, Middle) - QuinteDetention Centre Client Identi?cation No. Reason(s) for Segregation ?Date of Segregation 10/ 1 9/2014 Inmate advised of reason for segregation Inmate advised of opportuntiy for interview with Superintendent Protective Custody Institution Security Medical Inmate Request Inmate advised-of opportunity to make oral or written submissions inmate waives with Superintendent Name of Superintendent/Designate (Print) Signature 0 - in notes esign Date I Larry Shorts 10/19/2014 . . i - Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission - inmate is aware of reason for segregation and seems satisfied with current placement. Superintendent Decision El Release from K4 Continue Segregation Reasons: I . Third assault in a very short period. inmate serving penalty portion of misconduct. Name of Superintendent/Designate (Print) Signature of entl ignste Date - T. Sheil 10/23/2014 I Segregation Review (Inmate's segregation to be reviewed every 5 da Inmate Submission inmate stated he is doing ?ne. erview with Inmate robe conducted every 30 days) El Superintendent Decision Release from Segregation >11 Continue Segregation Reasons: inmate serving penalty portion of misconduct for third assault in a very short time frame. Name of Superintendent/Bosignate (Print) T. Sheil Date 10/29/2014 Signatu?ai? . Supplementary Report for each Subsequent 30 Day Period (use reverse offoml additions/comments). charges for threatening staff since being placed in seg. Comments Superintendent/Designate Signature . Date A /7 30 days. Written submission attached. Inmate in penalty portion of multiple misconducts and has three criminal 11/19/2014 csu 075-100 (10/04) 000007 siN/R v" Page 2 Regional Director Review . . - Continued Segregation Suggorted -- Not Supported I Ilm 01x 4% Mue. Name of Regional Director/Designate (i=rint) Signature of Regional Direc?to?iesignate Date 4294?: . "?e/be SLippiementary Report for each Subsequent 30 Period (use bottom of form for additional cemmenl?s Comments Signature Date Continued/Additional Comments by SUperintendent/Designate Comments Signature Date 521(1) Continued/Additional Comments by Regional Director/Designate Comments Signature Date i - - Distribution: Original - Region al Director (Only for Regional Director Review) Copy - File cso 000008 EEG-9.5 i .7 Ontario . QUINTE crang INMATE SUBMISSION FOR SEGREGATION REVIEWS. . Inmate Name;L OTIS Number: 's.21(1) Inmate written submission for 30 day segregation review: Inmate Oral Submiesion for 30 day Segregation Review: (To be completed by Sergeant) Inmate Signature: . If Witness Name: I ?92 . L1 Witness Signature: 'Date: 000009 . S.NIR - Ministry ?Community Safety ation Decision/Review . Ontarto and Correctional Services g? ?atBrockville Jail - 1 -- - \Qliintldenti?calion Name (Last, First, Middle)? Reasen(s) for Segregatidn i 7 Date of Segregation I: Protective Custody Institution Security Medical Inmate Request . 10/08/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral submis?ions Inmate advised of opportunity tor interview with Superintendent I El Inmate waives opportunity for interview with Superintendent Name of SuperlntendenUDeslgnete (Print) I Signature of Superintendent/Designate Date MoragAllan I - 7_ 10/08/2014 Superintendent Decision (This sect/0n must be cor/misled within 5 days ofihe inmate's placement in segregation) inmate Submission I Had been in segregation for the duration of time at OCDC prior to transfer to BJ- Requested to remain in segregation due to his disability Superintendent Decision Ci Release from Segregation Continue Segregaticm Reasons: request supported at this time Had a great deal of resistance in leaving OCDC health care unit. Feels strongly that he should still be there. HCU report their care of him is no longer required. Name of Superintendent/Designate (?rint) Signature orSuperintendenUDesignate Date Morag Allan I - - I 3 10/13/2014 Segregation Review (inmate?s segregation to be reviewed eyery 5 days. interview with inmate to be conducted every 30 days) Inmate Submission - . Continues to request segregation due to his disability. Superintendent Decision Release from Segregation E4 Continue Segregation Reasons: Request for segregation sUpported. Name of SuperintendenUDesignale (Print) 1 . I Signature of SuperintendentiDesignate Dale Morag Allan I - - 10/18/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date . Continues to request segregation. Supported clue to health issues - 10/23/2014 - Continues to request segregation. Supported due to health - issues. . . . 10/23/2014 - 321(1) 050 075.100 (10/04) I i 000010 Page 2 District Administrator Review .1 . Continued Segregation Supperled Not Supported . Comments - I . . Name of District Administrator/Designate (Print) I Signature of District Administrator/Designate Date Supplementary Report for each Subsequent?30 Day Period (Use bottom of form for additional comments . l. . - Comments Signature Date Encouraged to attempt-to climb stairs to dorm; with support. 10/28/2014 Wishes to remain segregated. . Continues to wish to remain in segregation despite many 1110212014 attempts at encouraging a new area. Continued/Additional Comments by Superintendent/Designate - Comments Signature Date . Mde/Wl? Encouraged again by supt to consider trying a dorm. Not 1110712014. interested at this time 7 . ReqUest on ?le to remain in segregation 11/12/2014 ContinUes to insist he requires seclusion from peers 1111712014 Still requests segregation. Encouraged again to consider a 1112212014 setting where interaction is possible offered. alternate accomodation'in this facility request to 1112812014 remain in segregation. - request to remain in segregation 1210412014 request to remain in seg. reviewed by health care/Dep. Sup 12/10/2014 and Sergeant see seg review data. Continued/AdditionalComments by District Administrator/Desi nate Comments Signalure Date - Distribution: original - Dial/1d Minimal/alt)! (Only for District Adm/ohmic: Review) Copy - lrtmaie File CSD 075-100 (10104) 000011 30' Day Segregation Review Data Form - SMR Elococ Elouinte inmate Name: I OTIS Reason for Segregation . - - . I .- El inmate isin need of protection - the inmates own reqUest 5'21?) El To protect the security of the institution or the safety of other inmates El Inmate is alleged to have committed a misconduct ofa serious nature - El 'Close confinement as a result of misconduct Specific reasonsldetalls for segregation reqUest to remain in segregation. . identify alternative placement options em" lored Wehave suggested alternate placement within the institution and other facilities and have met-resistance- - from We have offered him a living unit which houses only 4 inmates, we have offered him a singular cell 6n the first floor and offered him the possibility of relocating to another facility, all turned down. Does this inmate have Ontario Human Rights Code related needs? Yes_X No - . lf?E? 1 provide details (Le. Disability, .based on his Inluries _'Does this inmate have a Treatment Plan Yes_. lf? identify when it was last reviewed and the title of the reviewing clinical staff (Le. health care assist Date Released from segregation Additional Comments: Completedby: 07 . 000012 - i Ontario Ministry of Community Safety Segregation Decision/Review and Correctional Sen/toes . .leq-o/ il 7 WE Name (Last. First. Middle) Ciien\tidenti?catiory Date ot Segregation 08/18/2014 Reasoms?HB?r Segregation Cl Protective Custody Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions IE Inmate advised of opportuntly for interview with Superintendent lnmat waives opportunity for interview with Saperintendent Name of Superintendent/Designate (Print) Signature ?ne/him Date Morag Allan. Deputy Superintendent I 08/24/2014 Superintendent Decision (This section must be completed within 5 days of (he inmate's placement in segregation} Inmate Submission A requests that he go to a range. Superintendent'Decision Release from Segregation Continue Segregation Reasons: Concerns re releasing from seg due to Security issues. Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Allen - A - 08/24/2014 . Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Requests to be allowed to go to a dorm Superintendent Decision CI Release from Segregation Continue Segregation Reasons: Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date M. Allen A . i i 08/29/2014 Supplementary Report for each Subsequent?30 Day Period (Use reverse of form for additional comments) Comments Superintendent/Designate Signature Date - - 09/03/2014 CSD 075-100 (10/04) 000013 District Administrator Review . Page 2 Continued Segregation Supported Not supported Comments Kaye: /o JCDL- #0]me a; Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date I 001? 1/ - Supplementary Report for each Subsequent 30 Day Pen'od (use bottom of form for add/time] comments Comments i 1 I Signature Date I . - continues to require segregation. . 09/13/2014 .Continues to destroy? . 09/18/2014 . Continued/Additional Comments by Superintendent/Designate 7- Comments Signature Date . . i . Made serious death threats to staff member. Police called, 09/23/2014 7L. I 09/28/2014 assessment recommended by . 10/03/2014 Tranferred to OCDC for accommodation - i I -10/07/2014 Continued/Additional Comments by District Administrator/Desig nate Comments - Signature . Date MM/d?d/my Distribution: Original - District Administrator (Only for Dish-it: Administrator Rcm'cw) Copy Inmate Filo - cso 075-100 (10/04) 521(1) 000014 )Ontario Ministry of Community Safety Correctional Services Region. Eastern Month Ending Year August 2014 30 Day Segregation Report Summary \ps-iO?lq Name (Last, First, Middle) Client Identi?cation No. Date Segregated (0 Institution Nam Segre Continuing Segregation institutional Approval Reason for continuing Segregation Continuing Segregation Regional Approval Name Title: Other: Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select length of time . Name Title: Other: Signature .Name: Reason for current Segregation: Select Answer Reason: NO I: Comments: Approved by: Select Length of time Name Title: Other: Signature Name: Reason for current Segregation: Select Answer Reason; YES I: .No - Approved by: Select lenght of time Name other: Signature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select length if time Name Title: Other; I . Signature - Name: Reason forcurrent Segregation: . Select Answer . Reason: YES No Comments; Approved by: Select length of time Name'& Title: Other; . 7 Signature Name: Reason for current Segregation: Select Answer Reason: YES No Approved by: Select lenght of time' Name Title: Other; Signature Name: Reason for current Segregation:_ Select Answer Reason: YES No Comments; Approvec?j by: Select-lenght of time . Signature Distribution List: CSD 075-101 (rev. 10/08) Institution Copy Records Department, Regional Of?ce 000015 .CEACILITY: HOLD I PRINT TIME: 10:55 )5 . REQUESTED BY: I 1-- - -- - FROM: 01 Sep 2014 To: 30 Sep 2014 Ther? are up offehders held on Immigfation Only for within the requested date range. Page 1 of 1 000016 - FACILITY: IMMIGRATION HOLD . PRINT TIME: 10:50 REQUESTED BY: 7 I 1 FROM: 01 sep 2614. To:' so Sep 2014? . - I SAHR There are no offenders held on Immigration Only for BROEAA 7 . within the requested date range, Page 1 of 1 000017 'Ontario Ministry of Community Safety 8. Correctional Services 30 Day Segregation, Report Summary cso 075-101? (rev. mice) 2? Region ame: Month Ending i Year Eastern Brockville September 2014 Name (Last, First, Middle) Date Segregated Approval Continuing Segregation Reason for continumg - Continuing Segregation r; . . . Institutional Approval Segregation Regional Approval Client Identi?cation No. 1W9) . - Name: ?nil?repoi-t? . Reason for curr S?regation: Select Answer Reason: YES {3 No Comments: 55> 5? Select length oi time '3 Approve I AM hf 2% - Name Title: ,5 5 Other; Signature A Name: Reason for cUrrent Segregation: SelectAnswer Reason: YES No Comments; Imp Approved by: Select Length of time - Name a. Title: . Other: Sig nature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; ,Dg: Approved by: Select lenght of time - ?Name other; Signature Name: Reason for current Segregation: Select Answer Reason: YES NO comments; log: Approved by: Select length it time I Name a. Title: Other; I - Signature Name: Reason for current Segregation: Select Answer Reason: YES I: No Comments; mg: Approved by: Select length of time Name 8. Title: . Other: Signature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: I Sew-:6! 'engmf time- Name-g nother: I Signature 02 Name: - Reason tor current Segregation: Select Answer Reason: YES No Comments; 3 mg: Approved by: Select lenghtof time Name ?lial - Other: Signature 7? Distribution List: institution Copy ReCords Department; Regional Office 5 .1 _a 521(1) 000018 ftbontario Ministry Of Community Safety Correctional Services Region Eastern ion Name: ?3 Month Ending] Year August 2014 30 Day Segregation Report Summary Name (Last' First, Middle) Client Identi?cation No. Date Segregated Lawrence Valley Correrm egregation lnstitdtional Approval Reason for continuing Segregation. Continuing Segregation Regidnal Approval Name Title: Other: Name: Reason for current Segregation: Select Answer Reason: YES NO Comments:? I - Name Title: Other: Signature Name: Reason for current segregation: Select Answer Reason: YES No Epomments; Approved by: Select Length of time. - Name 3? Ti?ei Other: 7 Signature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select lenght of time Name 8: I other: Signature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select length if time Name Title: - . . Other' Signature 7 - Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select length of time I Name Title: Other; . 7 Signature Name: Reason for current Segregation: Select Answer Reason: 3YES [No Comments; Approved by: select lenght of time 7 Name 81 Other: Signature I Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select lenght of time Distribution List: institution Copy Records Department, Regional Of?ce 050 075?101 (rev. 10/08) Signature 000019 3? I Ontario ?Name (Last, First, Middle) Ministry of. Community Safety and Correctional Services Segregation Decrsroanevrew Ottawa-Carleton DentetLon Cent elem} genti?cation No. ~4 Reason(e) for Segregation Date of Segregation 06/24/14 mRequesL Protective Custody institution Securigg Medical mmate advised of reason forsegregation ?-{yeaavised of opportunity to make Orai or written submissions inmate advised of opportuntiy fer interview with Superintendent Inmate waives opportunity for interview with Superintendent - Name of Superintendent/Designate (Print) of Supe .m enUDesignaml Date Francis Nolet. Deputy Superintendent MM 06/24/2014 . . . ?r . Superintendent Decision (This section must be completed within 5 days or? the inmate's placement in segregation) inmate Submission . Superintendent Decision Release from Segregation 12" Continue Segredation I ReasonsAdmlnedtosegfo? . {Ee?pu?my who) Name 'of'SLJperintendent/Designate (Print) /mtfg:e:r: Date . . Francis Nolet. Deputy Superintendent 9?21;- i LL Segregation Review {Inmate's segregation to be reviewed every 5 days; Liam's-w with inmate td?ep?nducted evgy 30 days) . Inmate Submission Superintendent Decision {3 Release from Segregation .Z Centinue Segregation Reasons: - I ragabk? 0AA Name, of Superintendent/Designate (Print) ijswen Designate i Date . . . (a - 3 pf Supplementary Report for each Subsequent 30 Day- Period (use reverse-offonn for ad comments) -- Comments - SuperintendentlDesignate Signature Date . A i a can 075100 (10/04) 000020' Page. 2 Regional Director Review - Continued Segegation E7 Sugported Not Supported Comments . i . I Narne of Regional DirectorfDesignate (Print) - I Signature of Regional Director/Designate Date Supplementgy Fijport for each Subsequent 30 Day Period (use bottom of form for additional comma-rite . Comments Signature 1 Date; . Continued/Additional Comments by Superintendent/Designate - Crammean . Signature ?gate: . i - . I 0?5' fie/Ly?? \?xxrm xv}; Wok (b t? 1'11 - . [b'qr/f/ 23:3 MAN Ig' Li? o< mag-e?) he wal- my 16. 2g 80 \quMQ: . fb/Dq ?be. (D Continued/Additional Comments bLRegional Director/Designat . Comments? -- Signature Date i - Distribution: O?il?el - Raglonal Direaor {Only tog Regional Dimclor Review) Copy - Inmala Filo cso 075.109 (10/04) i '000021 Ministry of Community Safety . Segregation Decision/Review and Correctional Services . lnstitutio l_ OtiawaCarleton Denletion Centr Ontario .- Fe?n Name (LestI Firsl. Middle) Client identi?cation No. . Date of Segregation 08/2 9/201 4 Reagents) for Segregation . Protective Custody El Institution Security medical i:i Inmate Request advised of reason for segregation Mite advised of opportunity to me or written submissions? Waives opportunity ior in ewiew wilh erintendent 7 . inmate advised oLogponuntiy for Interview With Superintendent Name ofSuperintendent/Designate (Print) Signalur 0% Date Lab/a 1% 7 08/29/2014 Superintendent Decision (This section m'ust be completed within 5&3 of i igw??p/ecemeni in segregationi 14:: . -- inmate Submission . Superintendent Decision Release from Segregalion 12" Continue Segregelion Reasons: . - Admitted to Seg for: V. 2 5 db 5 Name of Supennte?ednmesignaie (Print) Signature oi Supe intendenl/Des' nete Date 6L /0 . ?gme?m?deh i 14/4/19? I 08/30/2014 c/ - VV Segregation Review (imnate?s?seg?regai/m to be reviewed every 5 days. into few With inmate to be conducted very 30 days} Inmate Submission . s.21(1) . . 5 if) Superintendent Decision DA Release from Segregation Continue Segregation Reas . . I DA 2 - Name ofSu erintendent/Designale (Print) Wynate Dale .7 - I I . - Supgiementary Rgport for each Subsequent SODay'Period (A ravage/ofi'om) for add/i/oi?commenis) 3 - Comments Superintendent/Designate Signature Date - cso 075?100 000022 Regional Director Review Page 2 Supported Continued Segregation i] Not Supported - Commenls - A - Name of Regional. DireetorlDeeignala (Prim) . Signature of Regional DIreclorlDesign?ata bale Supplementary Report for each Subsequent 30 Day Period (use bottom of Ram for additional comments) Conimenls Signature I Date . . Continued/Additional Comments by Superintendent/Designate I Comments . Signature Date 4/0 mtg(in; I [or I I (5 Wes-eke, xo ?azzj COntinued/Additional Comments by Regional Director/Desi nate - Comments Signature Dale? . - 5.141.114 A I I 4?11 .A A .. .4 ll AziizigDislribullon: Origlnal - Regional Director (Only for Regional Direer Revich Copy Inmaie File . 080 075.100 (10104) 000023 ?a?e?W l? Ontario Ministry of of Safety and Correctional Segregation Decision! Review We it: etention Centre Ottawa-Carleton Name (Last. Flret. Middle) . \Wnii?celion No. - Reason(s) for Segregation [3 Protective Custody institution Security El Medical El Inmate Request Date of Segregation Sept. 19/2014 inmate advised oi reason tor segregation inmate advised of opportunity to make Oral or written submissions Inmate waives opponuw for interview with Superintendent i:i. Inmate advised of opportunity for Interview with Superintendent Name of SuperlntendenUDe?nale (Print) 1 140mm, ouhh SI rperinte ndenUDesignate Data gust tee/H. I Superintendent Decision section must be completed within 5 days of the inmate's placement in segregation) Inmate Superintendent Decision Release from Segregation EY- Conlinue Segregation 'Reaeoner WSW-E +0 semst Mild Name of Sqrintendenlloosignate (Print) Sign? of SuperintendenUDeslgnate Date Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted ten/er 30 days) wee/t4 Inmate Submission s.21(1) Superintendent Decision Release from Segregation i3,? Continue Segregation Reasons: . b?Pr?t, 5 I 'Dale' 003m Signelure of SuperintendenUDesignate ?24?f Name of SuperiaendenUDeslgnate (Print) . 7 Supplementary Report for each Subsequent 30 Day Period (Use reverse oflorm foradditionaicommenis) Comments . SuperintendenUDesignale Slgnatme Date . CSD 075-100 (10I04) 000024 Page 2 Regional Director Review Continued Segregalion Supported Not Supporled Comments . . 570950449' - .- . I Name ol Regional DireclorIDeslgnale (Prinl) Signalure of Regional DireclorlDeslgnale Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of formYor additional comments Commenls. Slgnalure Dale Mdelm ContinuedlAdditlonal Comments by SuperintendenUDesignete 7 . Comments - - Signature . - Dale mew watkth C39 \5 amiable - I \0/04/30 0 . for recgudar manila 30 bemmw? 99-5 unpredxicinlok Riemann lei/l?ilmli 3C3 \hmvoke? \n?t?evulfwecl?) meek Bywme I An .. I- Qh?nen'i' 1:5th i \?/Hlaowl. ContinuedlAdditional Comments by? Regional DirectorID'eeighat 1 Comments - Slgnature Date I I s??qceholo?e 4190K Sec: \net in I A . M. MVP-CWL me) [peel . original - ?eglonal Dlraclm (Only For Regional Direclor Review} . Copy lnmala FM 030 075-100 (10104) . 000025 ye?. . 7'3 Segregation Decision/Review Ontario A Ll: me??wm?e?zef ocu? - /~1??iitutton? 1/ . Name (Lasi, First. Middle) i No. - Reason(s) for Segregation - Da-tegof Segregation Protective Custody institution Secur_liy Mdical inmate Request 091270014 inmate advlsed of reason [or segregation - El inmate advised of opportunity to make oral or written submissions. inmate advised 'ot opportuntly for Interviewwith Superintendent inmate waives opponunity iorinlerview with Superintendent Name Signerle niendentl signals Date - . Spike SGT . . 09?27?2014 Superintendent DeCision (This section must be completed within 5 days orthe Inmate'y?cement in segregation) Inmate Submission - . . s.21(1) Superintendent Decision I Release irom Segregation Continue Segregation Reasons: 1 Suicide Watch Name SignW?erIW Date- M16009Segregation Revrew (Inmate?s segregation to be reviewed every 5 days. late ew inmate to be oondrIcied-evary 30 dye) Inmate Submission . Superintendent Decision :1 Release from Segregation A, "j Continue Smggion Reasons: .ka A F5 I 1 9/37; 901701551 -. blame ofSu?p'enTrtendenUDeslgnate (Print) SlgnaWpartntend% Date . . Supplementary Report for each Subsequent 30 Day Period (use mve??Jr/fonnfor additionarao?menrs) Comments . SuperintendenUDeslgnate Signature 7 Date . 030 075?1 00 (10I04) ?000026 - 521(1) 'Regional Director Review . . Conlinued ?regatlon El/ Supponed El Not Supported 7 Comments - - ?ax/[oh-A2, Name of Regionai DireolorlDesIQnate (Brink) . Slgnalure of Regional Dlrecto?Designale Dale Kym/k; ?our?A - I swy Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signalure . Dale - ContinUed/Additional Comments by Superintendent/Designate . - Comments - .v . A Signalure:_ 3 .Date - L0 maloA (?anr/Ke, .. -- 0 "heel; 5U pnl'CKa/Mi/K .I Sig I l?whw?Pcr-?KMLQ. 5'0 Continued/Additional Comments by Regional Director/Designate Comments My, (pg/M 44? m4 Signature Date Original - Regional Director (Only lNRegiOnaJ UmaorRevlew) Copy?Inmate File s.21(1) cso 075?100(10104) 000027 -- i I Segregation Decision/Review -i . ext - . s.NlR - ?0ntario "?iO-?bhoi I loam ii0n . ococ - . . . Name eel. Final. Middle) \gient identi?cation nio. Reasonis) ior Segregation i I - . Dale of Segregation Protective Custody institution Security Medical Mimate Request 09/27/2014 inmate advised of reason for segregation Inmate advised Oi-Opporlunil to make oral or mitten submissions E3 Inmate advised of opponuntiy for interview with Superintendent Ci inmale?aives opport nlly for intervte With Superintendent Name oi SUper?intendeni/Designele (Print) 9 I Sigry/of upenntendw Date KW 5 ME I, 09-27?2014 Superintendent Decision (T his seciion must be completed within 5 days of piecemeni In segregation) inmate Submission 14(2)(d) . . s.21(1) Superintendent Decision Release from Segregation 7U 'Conlinue segregation Reasons: i . 7 SUICIDAL hiame SW - Date 7. 21/41606ng . 5, . VA i I Segregation Review (Inmate?s segregation to be reviewed every 5 days. .Inr(W with Inmaie to be cc cied every 30 days) Inmate Submission - - . Superintendent Decision Release from segregaiion I Continue Segregation- ?(Ms g4; dig/e, Name of SuperintendentlDeslgnale SiganperintendeW . Date - #11121 lop?? I Supplementary Report for each Subsequent 30 Day Period Luse arse arrorm comments) - Commen 5_ (/B?perintendent/Designate Signature Dale 075-100 (10/04) 4? ee?e?ional Director Review Page 2 Continued Segregation Supported Not Supported - - Comments I /G7gg7rf:7 ?2?29?xi::7 i4762p?wa?fK 077%5As Name of Regional Dlrectorlbeslgnate (Print) Slgnature of Regional DirectorIDeslgnate Date 22L?l?v1213 '53f4/24/ Supplementary Report for each Subsequent 30 Day Perlod?ise bottom of form for additional comments) - Commema- - Dme ?s.21(1) Continued/Additional Comments by SuperintendenUDesignate Conv?enm I 'SMnahne . _Dam (PP Uh?mi poem.)- 25* "7'14 I 2 WE I ,lC Q?in?fn? (Hum; A [our - Wm) WEE {IL/jut Aviawa (E'Ckk'54m \qu?Jlk Wkx?o use/in inn/Lg, bug/{- . Continued/Additional Comments by Regional Director/Deslgnate . - Comments Signature Date 0 -- - I .meme )d/M/?x/l ma?a/h/ M02 74% CSD 075-100 (10104) Copy Inmale Fhe Distribution: 069ml - Regional Dlreolor (Only for Regional Director Review) 000029 ream WE ME eeis Ministry of Community Safety . a rrec? not an I. [?10 9 088 Segregation Decision/Review . in)in oe-i we) Name (Last. First, Middle) Inst-lily . Otta a-Carleton Dentetion ngtre - Client Dete of Segregation . 07/28/2014 mmete advised of reason for segregation {3137123143 advised of opportuntiy for Interview With Superintendent ltheygm?tor Segregation Protective Custody Institution security Medical inmate Request BTnmate advised of opportunity to make oral or written Submissions male waives opportunity for interview with Superintendent Name of SuperintendenUDeslgnat? (Print) Francis Nolet. Deputy Superintendent Signature of SuperintendenUDesignate Date Superintendent Decision {This section must be templated within 5 dais or the inmate's placement in segregation) . 07/28/2014 inmate Submission I Superintendent Decision Release from Segregation Q, Continue Segregation: Reasons: Admitted to 3:39 for: 5a [?de i '1 s.21(1) Name of Superintendent/Designate (Print) Signature ?QperintendenUDesignate Date Francis Nolet, Deputy Superintendent A 07/29/2014 I Segregation Review (Inmate's segregation to be reviewed every 5 days.' interview with inmate to be conducted every 30 days) Inmate Submission . - Superintendent Decision Release from Segregation oil?JIM. tigJEC'i Reasons: .5 to . Continue Segregation Name of SuperintendenUDeslgnate (Print) Date 8?10-11 Signature of St! erlnlendenUDesignate Supplementary Report for-each Subsequent 30 Day Period (use reverse affarm rer additioneicomments) Comments Date Superintendent/Designate Signature C3D 075-100 (10104) 000030 I . Page2 a 'C"'Regi0nal Director Review . - Conlinued Segregatlon Supported . No! Supporled Comments . . I . . Name of Regional Dlreclo?Designale (Prim) Slgnalure of ?egional DlrectorlDesignale Dale ng . f? ?673/ Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . - Commenls Sign alure - - D'al'e ?1 Continued/Additional Comments by Superintendent/Designate . . Comments - Signature .. . - Dale MNMm?nww" 1? lag boon . .egg] 7S 7 ()an /0 Win Dow? 10' 063/" 09m I (D ContinuedlAdditional Comments by Regional Director/Designat 7 Comments - Signalure Date . . I M4 Ms? "4 I M/Iff-x 1 I - DIuMbullon: Original - Regional Director (Only rorRegiona! Dirador Review) Copy (:30 mm (10104) 000031 I age or he) Ontario Segregation Decision/Review iD?S?IO-dbi ~Or Name (Last. First, Middle) ?I?slitulion 0900? I ,7 net-150mb?) l0! oegregauon Date of Segregation 03 July 2014 Inmate advised oi reeson for segregation I Inmate advised of opportunity for Interview with Superintendent protective Custody Institution Secmity . Euteth El inmate Request Inmate advised of opportunity to make oral or Written submlselons Inmate waivos opportunity ior interview with Superintendent Name of Superintendent/Designate (Print) oi Superintenden signate . Dale a Uri/id? M13 JM 2014 .. I Superintendent Decrsion (This section must be compiered within 5 days of the inmate?s piaceme gin-aggregation) Inmate Submission Superintendent Decision Release from Segregation [13/ Continue Segregation ReasonsSuperini Date \3 Inmate Submission Name of Wdent/Designat (Prin?gE Hierr'cL' QMQ Segregation Review to be reviewed every 5 days. inx'ervlew With inmate Io r11 . Superintendent Decision Reieese from Segregation Continue Segregation Reasons: ?/Iedr?cagt Obseru?tf?oh Nawmienwj?nale wafsuperim Dale . . I or til/Li (M 07?01? i Supplementary Report for each Subsguent 30 Day Period (use inverse orrorm foraWammenls) - - _Comments -'Superintendent/Designate Signature Date s114t'2itd) s.21(1) 075-100 (10/04) 000032 Page 2 jegional Director Review - Continued Segregation 12/ Supported - Not Supported Ci Comments - 1 I I 434W ?44 . ?aky/?g? W7 . yLoC/x - . . Name of Regional Director/Designate (Print) I Signature of Regional DirectoriDesignale- Dale Kr . WE/k/i? Supplementary?Repon for each Subsequent 30 Day Period (use bottom of form for additional comments Comments . Signature Date Continued/Additional Comments by Superintendent/Designate Comments I Signature Dale 6235/ LL70 LUJ tut-91A 7* /4 log (Egle \Nxm i-Iry JQ-WK i? - x? Mo w:ngva vvJ?; . Ely/v lo- a; UK: rigzkg?xvxt Edna/ES. It 9?3" V135 \ttJU/t] 65> Continued/Additional Comments by?Regional Director/Designate Comments . Signatura' . Dale - - 7 . q" [lg41.1 a . drag??a?f Distribution: Original Regional Diramor (009i rochgional Dimar Renew) w? copy-inmateFlle 630 075-100 (10:04) -000033 a; aniline - . im?s?. I. Ontario . Segregation Decision/ReView S.NIR institullo OCDC {Name-(Last, Eirst. Middle) I Reason(s)- for Segregation Client [d Fnti?cation No. ProtectiVe Custody Institulion Security Medical inmate Request Date of Segregation 24 Sept 2014 Inmate advised of reasonjor segregation Inmate advised oi opportunin for interview with Superintendent Inmate advise? Inmate \maiveeI of opponunity to make oral orlv?rrillen subrnissions opportunity for interview Superintendent Name oi SuperintendenUDeslgnale (Print) a of Super ntendenUDesignale Signaturm . mm Data 24 Sept 2014 Piouffe I . I Joe or?! in gregation) inmate Submission - - i Superintendent Decision (This section must be completed within 5 days or the inmate?s pi Superintendent Decision Reasons: Release from Segregation Continue Segregation Name oi Ari/(b r2 arintendenUU signate . A ll 4 Dale 42745- Inmate Submission Segregation Review (lnma?a's segregation to be ravioli/ed 912er 5 days. into law wiMm are to be carrde 30 M) Aeocoqe a s.21(1) Superintendent Decision [3 Release from Segregation Cl Continue segregation Reasons: . I 3? 5a, win?~11. Name of Superintendenltoesignaie (Print) Date SWSuperinlendent?g? I - i 4 Ir gnaw/bf additional con?nisj comments Supplementary Report for each Subsequent'ao Day Period (1 Wuparinlenc entIDesignale Signature Date I CSD 075-100 (10104) 000034 Page 2 M. Regional Director Rewew - we Continued Segregalion Supported Not Supported Commenla - i Name of. Regional Diroaorlbesignate (Print) Signature of Regional DirociorI?Designaie Daie Eye/my - . I ?27 ocf? ma- Supplementary Report for each Subsequent 30 Day Period (Use bottom of form for additional comments) I Comments Signature Dale Continuededditional Comments by Superintendent/Designate Comments - .. Signature - - 1 Dale '10 Ir lb! ?warmed/AA (4.. i Iequ/?f? Cb - (Kala/Vi L?o/ Df iana/KQH [ad 39 I Continued/Additional Comments by' Regional Director/Designate A Comments - I Signaiure Dale - I . a? . mi Dialnbullon: Original - Regional Director (0an for Regional Dl?redor Review) . Copy - lnmalo F?o 051:) 075-100 (10/04)? . 000035 t, 3 5 Ontario A .0300 I Segregation .I jaw/oi /m sivna Na me (Last, First, Mindie) Client id? Wtion N0. . R753 Emits) ?Disagregation ProlecliVe Custody institution Security Medical Inmate Request M60 . Date of Segregation 24 Sept 2014 Inmate advised of reason for ?egregaiion - Inmate advised of opportuniiy for interview with Superintendent Inmate advisect of opportunity to make are! or wn'tlen submissions inmate waiVes 0 ortunitv forinlerview with Superintendent _i I Piouffe We of Superintendent/Designate (Print) Dale SU eriniendent Decision (This section must be completed within 5 de inmate sumeSsion . . Signalurt?mte ys 0f the {Ignata?s pie cemgn{ in segregation). 24 Sept 2014 Sueeriniendent Decision Reasons: I Release froth Segregation Continue Sggregaiion Name? of SUperintendentlDesignete (Print) (419qu WW uper ntendenw 7?7 - Dale oz (?219/ Inmate Submission I Se reggiion Review (Inmate?ssegre gallon to be reviewed euary 5 days. tnte Jetw?h inmt . ate in be Mary 30 days) Continue Segregation SuEerihtendent Decision 7 Reasons: Cl Release from Segregation w) 093 Name of SuperintendenUDesignete (Print)? SignW?nlendenUDea-Iy 'v . Date Mental)! Report for eaoh Subseguent 30 Day Period (use mvmp? Comments . S??eriniendenUDesignate Signature Date - MMIddvayy st21(1)' - I 7 W, 050 0754100 (torog) 000036 4 -IPageZ '?lstrict Administra'tor Review Continued Segregalion Supported - El - 'Nol Supported Comments - '6 ?11 m7? QMJL. . Name of District Admlnislramr/Designale (Print) Signature of Date WK 3 . 3104'106 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature - Date Continued/Additional Comments by Superintendent/Dggnate Commenls Slgnalure Date . JD ma?a) - . (oat-(w alas 0?08 1,048qu COntinuedlAdditlonal Comments by District Administrator/Desi nate . Comments Signatute -- - Dale . V.- p/ vv angina! Dismal Administraiar (Only for Review . Copy - Inmate Foe 7 7 521(1) 050 075-100 (10/04) '000037 J1. . if}; . i QSegregation Decision/Review . i 1/ Ontario . Wm /c/w0( - . _r . .0000? - a Name (Lasi. Firsi, Middle) Client Identi?cation No. Reasonis) for Segregalion . 7 - a! WV/waaie ofSegregaliori I: Protective Cuslody Secmily El Medical Inmate Request Mew ml, [5705: 23 Sept 2014 Inmale advised of reason for segregalion inmate advised of Opportunin to make orai orwriile'n submissions inmaie advised of opportuniiy for inierview wiih Superiniendeni Inmate waives opportunin [or inierview wiih Superinlendenl Name ofSuperinlendenllDesignaie (Pdni) Signature of Super Mden i male I Date Piouffe; 0 . i . 23 Sept 2014 . Superintendent (T his section must be completed wiihin 5 days of ihe inmate?s p?izemgni irisegrega?lian) inmate Submission . Superinie?ndenl Decision _'Reiease'fromSegregation Ei?i' ?Coniinue Segregalien Reasons: . i . \xn I Name ofSuperiniendenUDesignaie (Print) Signal/y? iendenUDes Segregation Review (Inmate's segregation i0 be reviewed every 5 day: Inierv' mime Inmate Submission Dale (9 I0 be conduoi every 30 days) Superini?endeni Decision Release from Segregaiion Coniinue Segregaiion Reas?qns: Cg) I -- Name of SuperinlendenUDesignale (Print) niendenUDesi 1e Date -- - 449?? Su??l?mentary Report for each Subsequent 30 Day Period (use rev?ss 'orm (dread/lions! OOMmenis) Comments - ?SiipariniendenilDesignaie Signature . Dale - 521(1) I - 030 0755100 (.1 0104) I - . 000038 (. Page 2 s.NlR 'Regional Director Review - Continued Segregation [31/ Supported El . Not Supported .1 Comments . . . . Name of Reglonal DlrectorlDesignale (Print) Signature of Regional DirectorIDesignale Dale b?Qz?v?\3 27 Ohm?7F" Supplementary Report for each Subsequent 30? Day Period (use bottom of form for additional comments . - - Comments - Signature Date COniinuedlAdditional Comments by Superintendent/Designate Comments Signature Date imwax-LQ f/ji, Mylo/?t? rmvol/31$ g/ terror?pgklolg {or/K- ContinuedIAdditional Comments by Regional DirectorlD?signate . i re Dat gram/u . 521(1) 050 075.100 (10/04) Dlalrlbulion: Original - Regional Director (Only for Regional DusctorRaviaw) Copy - Inmala File 000039 E5. . I Segregation De'ci?sion'lReviegiNm [Romano 83 (goon-c Name (Last. First, Middle) +\Clieni No. Reasonis) ior Segregation 7 - Dale of Segregation Pioiecllve Cuslody lnslitulion Security Medical lnmale Request 23 Aug 2014 inmate advised of reason [or segregalion '1 Inmale advised of oppoiiuniiy Io make oral o_r written submissions lnrhale advised oi oppor?lunliy for inie~iew Superintendent inmate waives opwy for interview wiih Superintendent Name of Sn riniondenilDeslgnale (Print) 7 SignalW Dale . gay (?11 7 j; - 23 2014 I . . Superiniendeni {This seciion musi be completed wiihin 5 days afihe inmate'sgla?mei'i?ln gegmgaiion) inmale Submission - Superintendent Decision Release from Segregaiion . CF Conl?inue Segregation Reasons: our! Begum . Name of SuperinlendenUDesignaia (Prim) I Date Segreqation Review (inmaio?s segregaiion in be reviewed every 5g; inlerview with inmate io be conducied every 30 days) inmate Submission - . - 9/ i'Superlnlendent Decision Release from Segregation Conlinue Segregallon Reagons: Othl? ?s?gwlj A Name of SuperinlenoenUDesignaie (Prim) I. Signature of Supe indenUDesignale Dale Mm . 9 s7 Supplementary Report for each Subsequent 30 Day Period (use reverse or form for comments) - Commenie' SuperintendanUDeslgnale Slgnalune. . Dale - . 521(1) 3.244233) CSD 075-100 (10(04) 000040 Page 2 ?1 Regional Director Review I . Continued Segregation - Supported Not Supported . 9- #7224475" 0w? - giant? Ive/??2 WWJ 514g Name of Regional DirectorIDe?slgnale (Print) Signature of Regional Director/Designate Dale 00,? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) - commonls Signature Dale - - Continued/Additional Comments by Superintendent/Designate Comments . Signature . . ,Dale 3: amok], 4 ~97 40 gamma 1:0 45:. *Spc43w-oxcek ?10- 1*?lbf Sb mmw? Io? it; . - Sec-tart.th . I ADI 93': (Y ContinUedlAd'dilional Comments by Regional Director/Designate - - Comments Signature - Date I gi?L ML WW . .Vrv M.M??y?rw yam/?XLan Olil?hulleut aroma war 5- lz?zud? Copy?[Whale Filo 521(14)? 030 075-100 (10104) '5-21i2lif) or Review) 000041 a vy- -, Ontario Ministry of Community Safety end Correctional Services segregatlon Dec'SIOII/Revlew - Sheen Reason(s) for Segregation In uiion I QZWa-Carleton Dentetio?jcgit - I Name (Last. First. Middle) Client identi?cation No. div Dete'ot Segregation 9/21/14 B??rotedive Custody. insiltuiion Security Medical inmate Request mnmete advised of reason for segregation Inmate advised of opponunily to make oral or written submissions Mmate advised of opportunity for intentiow with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of SupenntendentlDesignale Date . Superintendent Decision (This section must be completed within 5 days aHhe aie's placement in segregation) Inmate Submission superintendent Decision Release from Segregation El Continue Segregation Reasons: . Admitted to Seg for: [Km L1 Name of SuperintendentlDesigneie (Print) Signature of Superintendenuoesignate Date Pat Barnes, AlDeputy Superintendent Segregation Review (Inmate?s segregation to be reviewed every 5 days. I interview with inmate to be conducted every 30 days) Inmate Submission - Superintendent Decision El Release from Segregation [3 Continue Segregation DAY: Reasons: Name of Superintendeniloeslgnate (Print) Signature of SuperintendenilDeslgnaie Date 4 - Gertbt Supplementary Report for each Subsequent 30 Day Period (Use neverse offon?n {or additional comments; Comments Superintendeniloesignate Slgnature Date . cse ovetoo (10/04) 5'21?) - se21(2xr) 000042- 0 Regional Director ReView Page 2 Continued Segregalion Supponed Not Supported Commanls Name of Reglonal DirectorIDaslgnate (Print) Slgnalure of Rogional DIreclorIDesignato Date Suppiementary Report for each Subsequent 30 Day Period (use bottom of form for additional'comments Commonls - Signalura Dale . I ContinuedlAdditlonal Comments by Superintend?nUDe'slgnate - - Comments Signaturo .- . 'Date A . l0 {62/ u-(m-wmru?xloh am 31; . [13* 31- - Continued/Additional Comments by Regional DirectorlDesignate . Comments Signature Date - A muf?e. gimme? ?r ?a (loamy a; or *Qm We ?0qu 0K9 mm NYE Ve?nk 30 6 Hum?; a oLS-x A i (0-214-9- I Dlalnnuuon: Original - Regional Dlredor (Only IochanaI DImdorRaviaw) 7 Copy- lnrnaia Flla I 5.21 1 050 075?100(10104) . 000043 - an it 0ntario Ministry of Community Safety and Correctional Services 45A 715% Segregation Decision/Review zln? Ottawa?Carleton Dentetion Cenirx Name (Last. First. Middle) 53 'Ci' lid . - .- \\ien enlcallon No Reagents) for Segregailo Protective Custody . Milan Security :1 Medical inmate Request ?xv-Bile of Segregation 9/21/14 E'Minate advised of reason for segregation - Inmate advised oi opponuntiy for interview With Superintendent inmate advised oi Opportunity to make oral or written submissions Inmate waives opportunity for interview with SUpen'ntendent Name of SuperintendentiDesiQnate (Print) Signature of SuperintendentiDesignate Date M7 7-1" ?i - Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission - . Superintendent Decision CF Release from Segregation l3"? Continue Segregation Reasons: . Admitted to Seg for: n) oed- Name of SupenniendenUDesignate (Print) Signaw tendentiDeslgnate- - .Date Pat Barnes, AlDepuly Superintendent 04?1-1 ?i \i Inmate submission I Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to Die conducted every 30 days) Superintendent Decision Ci Release from Segregation B, . Continue Segregation Reasons: DAY: Name of Superintendent/Designate (Print) Silm?rcm? Signature Weslgnam Dale - I Supplementary Report for each Subsequent 30 Day Period (use reverse ottomi ror additionaicomments) Comments SuperintendenUDesignaie Signature Date 7 s.21(1) 1- i - cso 075-10'0 (10/04) 000044 Regional Director Review Page 2 Continued Segregation 13/ Syporled Not Supported Comments 374mb meme/2,. Name of Regional DlreotorlDesignate 1 Signature of Regional DirectorIDesignala 0 Dale 10?? - for additional comments Supplementary 'Report for each Subsequent 30 Day Period (use bottom. of form 'Commenls Signature Dale Continued/Additional Comments by Superintendent/Designate 1 Comments Signature Date I Lo . . 2? Ml'scomuhl? 4,11 \l?JMpmiSCon'duf - 11 80 - . Continued/Additional Comments by Regional Director/Deslgnate -Commenls Signature Dale I IANTC lurelurmueD WM 31(1va 1: -l0 Iona Mame"? ?(-696ng - a 30 Dow MAY 9mm 0.4 heft 4 Low ?0 mm (Mag/i {7.94; mag {tau/205;? . 111449715. M40: vm . /7 I um ribullon: - Regional Director (Only for Regional meow Review) 521(1) C3D 075-100 (10/04) Copy - lnrnale File 000045 3m i?e . Ontario .s. . isegregation Decision/Review Name (Last, First. Middle) Roason(e) for Segregation . Protective Custody Institution Security Medical . Instituti0n eognc? I Date of Segregatior 22 Aug 2014 El Inmate Request I Inmate advised of reason for segregation Inmate advised of opportunliy for interview with Superintendent Inmate advised or opportunity to make oral or Written submissions inmate waives opportunity [or Interview with Superintendent 'Name of Superini denUDeelgnate (Print) Signature ofSupe - - - Dale 7 (calf/? 22 Aug 2014 Superintendent Decision {This' section must be completed within 5 days orthe inmaiOZplacen?ent A segmgei?i) Inmate Submission 7 i Superintendent Decision Release from Segregation Cl Continue Segregation ReasonsName o?uperintendentioeslgnate (Print) Signature (3an Date ?93 Segregation Review (Inmate's eegregat?t?an to be reviewed every 5 days. interview with inm'ete' to be conducted every 30 days) Inmate Submission 2 . i 1/ Superintendent Decision Release from Segregation Continue Segregalion Reaso@-\ a t) 0?0; . Name of SuperintendenUDesignaie (Prinl) Signature of SuperintendentlDesignaie Date . winner 97-41? supplementary Report for each Subsequent 30 Day Period (use reverse arrerm foreddirlonaloomments) . Comments . - SuperlntendentlDesignate Signature Date . 050 075-100 (10?04) 521(1) 000046 I Di'srricl Administrator Review Page 2 Supported Conlinued Segregation Not Skipploned- Comments . - Name of District Administratorloeslgnale (Print) Signature of Date Kr Dom; 7 024?- [f Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Commenls Signature Date . Continued/Additional 00mments by Superintendent/Designate - Comments 7 Signature .Dale 2: WJ was GnuW03. 3b: {1-qu gs? Am 1v (art?- to Mr) Ms Con?nuedlAdditional Comments by District Administrator/Desi nate . SMnmum Dam WHITE: IMUTWEQED MD 15 ?ex/MM Sums-MM a? mum -c?certvn'nm 1mm Mote/3L (Al/40ft; . gr! ?t Ema) \u re gram {-4va A NIR Dlamnullun: Original - Dish-id {Omy [or District Admin?iSU'atarRewew) si14(2)(d) Copy-InmateF'rIa cso 075100 (10104) 5'21?) 000047 HE a SE ?in? Ontario Ministry of Community Safety and Correctional Services segregatlon Reasonis) tor Segregation A ?institution . - Ottawa-Carleton Dentetion): ntre Name (Last. First. Middle) . .J Dale of Segregation 08l22l2014 Protective Custody B'i?stilution Security Medical inmate Request anmate advised'oi reason for segregation B?inmete advised of opportunity to make oral or Written submissions web advised of opportuntiy tor interview with Superintendent mate waives Opportunity for interview with Superintendent Name of SuperiritendentiDesignete (Print) Pat Barnes, A/Deputy Superintendent Signatu of Superintendent/Designate Date 03/22/2014 superintendent Decision IT his section must be completed within 5 days of the Inmate's piecer'nent in segregation) inmale Submission i? I Superintendent Decision Ci Release from Segregation Continue Segregation Reasons: Admitted to Seg for: I Ll awn?i Name of SuperintendenUDesignale (Print) 08/23/2014 SignaVCp?aq'ntendenUDesignate Date Pat Barnes, AIDeputy Superintendent I . . - Segregation Review (Inmate's segregation to be revieWeo? every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release irom Segregation I Continue Segregation . Reasons: DAY: mTr?-?i" Name of SuperintendenUDesignate (Print) Signature uperintendenUDesignate 7 Dale Supplementary Report for each Subsequent 30 Day Period (use reverse afform comments) Comments SuperintendenUDeeignate Signature Date t: 91(1), 05D 075-100 (10104) 000048 Page 2 0 Regional Director Review . Continued SegLegation Supported Not Supported Comments - - . Name of Regional DirectorlDesignale (Print) Signature ofRegional DirectorIDesIgnate 0 Dale Knows 2?7 oer 4; Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments Signature Date ContinuedlAdditional Comments by Superintendent/Designate - Comments Signature Date A 7. - I i- qmg?a?i?f a? 'tnwwituu LIC mm lav-Qav?-l 50 iWMpwu. dim/r mm 65 thmelozt [or/ro?/g/ Lib . I Br 15/ Continued/Additional Comments by Reglonal Director/Designate I - - Comments . -- - Signature - Date [mum mun. {kaowr' u: ?qkojmw-J?i [)ch 0571 (AK mug WM:on Qc?m'rnm?rry mum Mm (scum. ?new - . 10-11417. Not 97 TM not. aim s. i 4i2)(d) _s.21 (1 21 Dtsl?bulton: original a Regional Dirauor (ow [orRegianuI Cimdor?etdow) Copy Inmate File CSD 075-100 (10104) 000049 ram-?? I and Correctional Services . - Ottawa?CarletonDentetion Centre Name (Last, First, Middle) 3:5 a 'e Ministry Of Community Safety Segregation Decision/Review . - Ontario Roason(s) Ior Segregation I - I Datmf Segregation Protective Custody institution Security Medical El Inmate Request I . ammo advised of reason for segregation Den-lair; advised of opportunity to make oral or written submissions inmate advised of opportunity for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name oi SuperintendenUDesignate (Print) Signature of uperintendentlDesignate Dale 9) (SMAR- - - Superintendent Decision (T his section must be coyieied within 5 days of the inmate 's placement in segregation} Inmate Submission 1 werintendent Decision El Release from Segregation - . Continue Segregation Reasons: Admitted to Seg tor: an Name ofSuperintendenUDesignate (Print) Signature 0' ,erintendentlDesignate Pat Barnes. AIDeputy Superintendent Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview with Inmate to be concluded eVery 30 days) inmate Submission . . 07 Superintendent Decision - Release from Segregation El Continue Segregation Date Reasons: PAY: 09w? Nameo SuperintendenUDeeignate (Printt - i Signature ofSuperintendenllDesignate Date - "Wim- gr?i?ri?f . I Supplementary Report for each Subsequent 30-Day Period (use reverse orlorm fer additional comments)? CommerggNIR SupenntendenUDesignate Signature . M??ej?yw - 3.21 (1 (:50 075-100 (1oro4) 000050 kw. Regional Director Review Page 2 Supported Continu?ed "Not Supported VM'bA-fk Name Signature ofReglonalDirector/Deeignate Date ?l?M/wg Kmx?Q 2.7 at;? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments I . Signature Date Continued/Additional Comments by Superintendent/Desig?te . Comments I. - Signature Date t3? 1-0/1 lit-I \3 It? 3 Duivx Mum In, (.0, 25?- Own 33/ "1,0900% 0 con Slay/(C Continued/Additional Comments by Regional Director/Designate Comments Signature Date INFEer?ch 10le 7: 'Id? Sac 0F QR egau?lcx (on; p" Salome m?m (Li (I 1 OWL @e?m mu Mme 4th U?k! 2: Enemy YER A I .5210)- NH e?Zf?Iy, . Distribution: Regtoml Diledof (0an tor Regional Director Review: Copy Inmate ?le 030 075-100 (10104) .000051 Ministry of Community Safety . Segregation Decision/Review . do t. .3 . an Offec Iona C33 Ontario AXE W/Orl?i?Oi . ii) I institution 7 n) Ottawa?Carleton Dentetion Centre Name (Last, First. Middle) Client identi?cation No. - Reason(s) for Segregation I Date of Segregation Protective Custody E'?t'sililulion Security Medical Inmate Request 08/18/2014 mmate advised of reason for segregation I animate advised of opportUnily to make oral or written submissions me advised of opportuntiy for interview with Superintendent Wale waiveyp?ermnity lor interview with Superintendent Name of Supe?ntendenUDesignaie (Print) Signature of S?ennten nUDesignate I Date Pat Supeiintendent 08/18/2014 I Superintendent Decision This section must be completed within 5 days of the inmate's piacement in segregation) Inmate Submission - . "a SuPerintendenl Decision Release from Segregation (a Continue Segregation Reasons: - - 'Admitted to Seg for: misconduct Name of SuperintendentJDesignate (Print) Signature of SuperintendentiDesignale Dale Pat Barnes, A/Deputy SUperintendent 03/19/2014 Segregation Review (inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission - 6/ Superintendent Decision Release from ?Segregation El Continue Segregation Reasons: DAY: my Mn Nameguperlntendentmesignate (Print) SWesignate Date - Supplementary Repon for each Subsequent 30 Day Period (use reverse arrorm for additional comments.)- Comments SuperintendentiDesignate Signature - Date MMIddIm'y - Kn cso 075100 (10:04) 000052 I Regional Director Review ?Conlinued Segregalion Supported Nol Supported Page 2 Commenle f?A,70 MAM MM .. @wx Wow/?- g4 Mpg-442?. 4&4; W444 Dale Name of Regional Director/Deaignale (Prinl) Signalure of Regional DireclorlDesignale . K'D??xmiS a? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - Comments Signalure Date Continued/Additional Comments by Superintendent/Designate Comments Signature Date ?1 3 (9mm ma?a?u 9? 9 UM Mud-43F go (F (0 ever?, Nay-4k lo? 151 7? Lo in Ulla/L! I Lann? 15? Continued/Additional Comments by Regional Director/Designate . Comrrienls Signalure Dale LAVM amvgm/ Mic/W Via/f r4 544,4 5/141/ 1 AM. /729/, I s.21(1) .CSD 075-100(10104} Dismbuuon: Original - Regional Dimclo: (Only (orRegiona Di Copy - lnmale 000053 Ontario Segregation Decision/Review A 6% 0000 . I Name (Last. First. Middle) Reagents) tor segregation Protective Custody IE Institution Security El Medical agate Request Date of Segregation AUG 21 2014 Inmate advised of reesontor segregation inmate advised of opportuntiy for interview with Superintendent inmate advised of opponunlty?to matte oral orwrillen submissions inmetewrlaives opportunity for interview with Superintendent Name of SuperintendenUDeslgnale (Print) - - Signal uperln endenUDesign to - Date GODIN AUG 21 2014 Superintendent (This section must becomplatod within 5 days of the inmate?s placement in segregation) Inmate Submission Superintendent Decision Release from Segreggtion Continue Segreg?lon ?gsons; - nerumm LM ML. arm WH- We 0?15") Name of Superintenden eeignale (Print) Signature SWgnete Date fig - uL . aid-"L I Segregation Review (inmate's segregation to be reviewed Wear 5 days. interview with inmate to be conducted every 30 days; I g; Submission El Superintendent Decision Release from Segregation Continue Segregation A Name of SuperintendenUDesi nale (Print) Signature ofSupa lehdgnUDeeignale Dale 3- see Supplementary Report for each Subsequent 30 Day Period (use reverse orrorm comments) . Comments i Superintendent/Designate Signature Date . - 5.21 (1) 'e min n15-1nn r1 000054 Re iorfalDireoior Review Page 2 Ci Continued Seg?gation 9/ Supported Not Supported Comments - Name of Regional DimctorIDoslgn'aie (Prlni) Signaluroof Regional DirectorlDesignale Dale K~b9m13 2?7ch ?g Supblemeniary Report for each Subsequent 30 Day Period (use bottom of form for additions/Comments Comments Signalure Date MMIddI?ym Continued/Additional Comments by SuperintendentlDesignate Comments I - . - Signature Date I . . 85 ??er Wt r3 wk 61?95 ,0 9-3o?l?f I y/ Hg ma?a: in) Lulu-V}, .. Sb P?er?u'xva 1 Cr 5; WW3 . /Ir LE) reReval lmw?r? Conlinued/Addiilonal Comrnenis by Regional Director/Desimate Comments . Signature - Dale - - I Mucous?) AMI It? know Remap-21k- %l an M1 AQJL an en; amt-(7 (J 5 um Rams Mm - Mum 9 newt Sud/ea svw! MN 10-3049 a. I?I?Lnuf . ~s-21m - Disirihulion: priglnal 5 Regional Dirodor mama: Regions! made! Review) Copy - Inmale File cso 000055 .Ontario I Ministry of Community Safety and Correctional Services Segregation Decision/Review Name (Last. First. Middle) - in tea-Carleton Dentetion Cab . Reasoms) for Segregation Clienwon No. Inmate Request Date of Segregation 08/20/2014 anmate advised of reason for segregation Protective Custody Institution Security Medical advised of opponunty for Interview with Superintendent gym-late advised of opportunity to make oral or written submissions inmate welves opportunity for interview with Superintendent /7 Name oWW?nt} i Name of Superintendent/Deslgnate (Print) Signature of Wmte .Dale Pat Barnes. AlDeputy Superintendent 08/20/2014 . I. superintendent (This section must becomp/eted within 5 days of the Inmate?s placement in segregation) inmate Submission - Superintendent Decision Release from Segregation Continue Segregation Reasons: . Admitted to Seg for: Ml Name or Superintendent/Designate (Print) Signature of Superintendent/Designate Date Pat Barnes. AlDeputy Superintendent 03/21/2014 Segregation Review (Inmate's segregation to be reviewed every 5 ?days. Interview with inmate to be conducted every 30 days} lnmale Submission . Superintendent Decision Release from Segregation Continue Segregaiion ReasonsSignature of Superintendent/Designate Date Supplementary Report foreach Subsequent 30'Day Period (use reverse of form ror additional comments) Xxx-19? Comments Superintendent/Designate Signature Date . I MM/dd/my s.21i1i 030 075100 (10/04) . 000056 - Paga2 Regional'Director Review . . . Co?tlnued Segregallon Supported El NotSupponed Commonls . I I MIL Name of Regional DlreotorlDesignate (Prim) Signalure of Reglonal DirectorIDeslgnato Dale (If/Brae. our r74 Supplementary Report for each Subeequent 30 Day Perlod (use bottom of form for additional commenfs - Comments Signalure - Data ContinUedlAdditional Comments by Superintendent/Designate - - Commenle . - Slgnaluro Date '36 jib/Jug] q/D NwaK' I el-aiaIJ wdrc?ML I '10" 56> MAMA A 9~ zcy 44 rcI/? I . - 0 7 Continued/Additional Comments by Regional Director/Designate . I Comments -- Slgnature 'Data .[Hm (?mtg-eel) 9,4,9 be? we . I Mira: Flu?F (Leary - Uu?? Mt YvEMrrm' <5th 7031? - . - s.21(1) I . . - Original-Regional Copy-Imam File 030 075-100 (101'04) I 000057 an I I II I I -2521) . . Segregation Decrsroanevrew Ontario. Pg - .0 A I tumn - if 0000 A I lName (Last. First. Middle) ?4 No. Reason(s) tor Segregation 1 . Protective Custody institution Seounty El Medical Inmate Request Dale of Segregation Sept 12 2014 Inmate advised of reason for segregation Inmate advised'ofopponuntiy for inteririew with Supenntendenl aka oral or written submissions inmate advised of opport /er?r Inmate waiger pp ity p?ewlew with Superintendent Name of SuperlntendenliDesignale (Print): ?em/ Name or SuperintendentlDesignale (Print) Signature 0&6qu t? nate Date Sebastien Cote 09-12-2014 Superintendent Decision (This section must be completed wiUrin 5 days of the inmate's placement in segregation). . Inmate Submission I . Superintendent Decision Cl Release from Segregation - Continue Segregation Reasons: i m3 ates. Signature of Super Moment/Designate Dale Inmate Submission I I. Iv Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with to be conducted every 30 days) Superintendent Decision I Reasons? W3 Release from segregation Continue Segregation Name of Superintendent/Designate (Print) A . signature my?t?nw Dale ?rm-H Supplementary Report for each Subsequent 30 03: Period (use reverse of form additioneicommonts} Date Comments Superintend nIJDeslgnate Signature 91(1) 030 075-100 (to/04') 000058 a - .uR?egional Director Review . Not Supported Page 2 Continued Sg?egatten - Supported - Comments/?mp?rq . Name of. Regional DirectorIDeslgnale _(Print}' Signature of Reglonal Director/Designate Date 5 Z7 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date . MMIddIyny Continued/Additional Comments by?SggerintendentIDesignate Comments . Signature Date to own Wee}? 4?91zo??rw/ I {b ED :3th 94$ '9 5" I Continued/Additional Comments by Regional Director/Designate Comments Signature Date - . YPL r? I ngvf294 (at/f! Ali/144 Mqu/? 4/545 /21/f AW ?J?t2ildi s.21(1) tonal Directs: {Ody {Dr Regional Dinacior Review) 3.21 Dlat?hutlon: Odette-t - Bea 075100 (10:04) Copy - tunate Fits 000059 Sagan - -F?Ontario Segregation Decision/RevieW- FAKE . i I . - 3' - OCDC: - NameiLast. First,dedie) be. Client No.) . . Re?asonts) ior Segregation Dale of Segregation 09/1 8/2014 i - - - . Protective Custody institution Siecuriiy Medical inmate Request Inmate advised of reason [or segregation inmate advised of opportuniiy for interillewtviih SUperinlendent lnrriate adviseao/fo pawn ake oral or Written submissions inmate vgaiu? with Superintendent Name of SUperiniendenUDosignate (Print)' . Sebastien Cote, Sergeant Signatur fSupe Wg?ate Date . 09?13-2014 . . . i Superintendent Decrsron (This section must be completed wimin 5 Inmate Submission v. g7 i days at the Inmate 's placement in segregation) Superintendent Decision Reasons: .5 .h for crop '9 El Release from Segregation Coniinue Segregation 3' WI Name of SuperintendenUDaslgnale (Print) Signature of anew Date inmate Submission Segregation REVIEW (inmate?s segregation to be reviewed every 5 days. Interview with to to be conducted artery 30 days) >&mr Superintendent Decision Release from Segregation Continue Segregation . . Reasons: at at an I. i Name of SuperintendenUDesignate (Print) Signature ofSupor moment/Designate . Date Supplementaryr Report for each Subsequent 30 Day Periodn we reverse of form raddr'iionai comments) 9. 234?! . Comments 1 Superintend enUDeslgnele Signature Date 0414\l 'cso (175100 (10104) 000060 1' 5' 'Regional Director Review . Page 2 Continuad SegreganJn Sgpported - Not Syppoded fo?wcla?? .- Dlsl?bumn: Originni - Regional Binder (Only for Regional Diredar?ewaw) I Copy-Inmate Filo CSD 075-100 (10104) Name of Regional DltedorlDesignale Signalme of ?egional DlreclortDesIgnale Date K6 TEN I 1?7 a?cr? ((71 Egon for each Subsequent 30 Day Period (use bottom of form for additional comments - Comments -Slgnalure Dale Continued/Additional Comments by Superintendent/Designate Comments Slgnalure Date . . . ?3 Q?ai'l73c: ConllnuedlAdditionel Comments by Regional DIreclor/Designate - Comments - . Stgneture -Data - . - . - . I 19/ ?y (014414.. '1 Cal 1L AIC57 tLb!? 511- f; 1 1TOA.L: 1412 ., - 3721(1) - 000061? We 1 Ministry of Communi Ontario Segregation Decision/Review Ins and Correctional Services I NametLast, First, Middle) tiawa-Carieton Dentetim Client Identi?cation No. Reasonts) tor Segregation Protective Custody Institution Security El Medical [:Iinrnaie Request 4331?: of Segregation 9/ 1 3/2014 B1nmale advised of reason for segregation- B?l?n?rate advised of opportunity tomake oral or mitten submissions El Inmate waives opportunity for-interview with Superintendent QWB advised oi opportunity for interview with Superintendent am . olr SUperintendentlDesignale . Signature of SuperlntendentlDesignate Date WW (- 54 qu-?MU Superintendent Decision (This section must be 5 days of (be inmate's placement in segregati?rl Inmate Submission Superintendent Decision Release from Segregation 12", #Coniinue Segregation Reasons: . . Admitted to Sag for: (905 Name at SuperintendentIDesignate (Print) Signature of Superintendent/Designate Dale Pat Barnes, A/Deputy Superintendent 00' i 7 Inmate Submission Segregation Review {inmate's segregation to be reviewed every. 5 days. interview with inmate to be conducted every 30 days) 1- [Nu-(Lb 0b Superintendent Decision El Release from Segregation Continue Segregation Reason 5 Name of Superintendent/Designate (Print) Signature of SuperintendenUDesignaie Date 3* Supplemental Report for each Subsequent 30 Day Period {use'reverse oriarm for additionelcamments) . Comments Superintendent/Designate Signature Date s.21(1) CSD 075-100 (10I04) 000062 Page 2 ?Eeg?onai Director Review __C_ontinued Segregation Sugported Ci Not Stmported Comments I . . - Name of Regional birectorIDesignate (Print) Signature of Regional DirectorlDesignate Date a 0 27 ac? ff. Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) 7 I Comments Signature I Date Continued/Additional Comments by Superintendent/Deggnate Comments Signature -Date . 1-, MdeW 9.1moi-t - :04,ka 30 W5 both 007 I ContinuedIAdditionai Comments by Regional Director/Designate .7 . Comments Signature . -- Date . 'MMIddlm rummwwiewo [@515er .9 LNML Uut?C drawing (?71 FM 1111} ow gym?IL ?gf?t'f?n WEN 05% (Etta/1 atvw ?r ?aw/?a TM: (?twink am A 5. NR . . Dintnhuuon: O?ginal - Regimai Director (Only for Regional [Elector Review) 5.21 (1 Copy - inmate F06 cso 075-100 (10104) 000063 FEE FED, . I 03,? . Ontario Segregation Decision/Review HOS -t(3~iu ~02! lnslilutio ococ I Name (Last. First, Middle) - Client Id Reasonts) tor Segregation i enli?celloryb. Date of Segregation Inmate advised of reason for Inmate advised of opportunliy fer mien/law with Superinlondent Protective Custody Institution SIecurin '3 Medical Inmate Request Inmate advise: lnmeie waives of opportunity to make oral or written submissions opportunity for Interview with Superintendent Segregation Review (inmate?s segre geiion to be reviewed eVery 5 days. Interview with inm Name of SuperintendentiDeelgnele (Print) Signature of - - Dale Sebastien Cote, Sergeant .1 09/19/2014 Superintendent Decision (This seciion must be completed wiihin 5 days of ihe inmate?s placement in segregation) I Inmate Submission I Superintendent Declslon El Release from Segregation Bf Continue Segregation ReasonsName of (Print) Signal of Super'ntendenUDesignaIe Date 3> {941% vie?mi Inmate Submission 1 Lie to be conducted every 30 days) . _i Superintendent Decision Release from Segregation Continue Segregation Reasons: i $Superintendenlmesl nale (Print) dries-ii (Emu Bye ofSuper Dale 929%? Supplementary Report for each Subsequent 30 Day Period (uselreverse oHonn Jr ad i comments) Commentfs . SuperintencenUDesignale Signature I Date - . - ti.i4t2itdi cs0 ore?ion (1 0104) 000064 Page 2 Regional Director Review . . Co'nlinued Segregation Supponed ommens?ildw?dv 4.0 WW0 WM -- Not SUpporied Name Of Regional (Print) Signaluredof Regional Erector/Designate Dale I {fl- Supplementary Report for each Subsequent 30 Day PeriodJuse bottom of form for additional comments) . - Commenls SignalUre Dale ContinuedlAddliionai Comments by SuperintendentlDesignale . Comments . Signature Dale . 4 5'14 h: $6,94be 70 541.1ng 0' [o awhContinued/Additional Comments beeglonal Director/Desi nate Comments Signature g_ Dale - (Nut-Minx?) Jl' 2} ?rm QCLEMTM Doc: ?25 MUME Uu Mfg?(7054' I. I - ?r m: li/L. My! - umpc ?ch?x 7 lo 7 A 821(1) :3 Dis! button: ml - ional Oiledor {Oniy forRagionamimcloikeMew) $.21 Copy-Inmale File can 075?100(10104) 000065 and Correctional Services I In WILD A awe-Carleton Dentetion Centre Name (Last. First. Middle) . - C: 'CiieWion No. Date ofSegregation some) tor Segregation . 5Protective Custody El Institution Security Medical Inmate Request 07/19/2014 90mm advised of reason for segregation - glamate advised of opportunity'to make oral or written submia'slons In mate waives opponunlty for Interview with Superintendent Ministry of Community Safety Segregation Decision/Review 7 Ontario Inmate advised of opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Signature of 8 tan UDeaignate Date Francis Notet. Deputy Superintendent 07/1 9120-14 . r' Superintendent Decision (This section must be completed within 5 days of file inmate?spiacement in segregation) Inmate Submission - . I Superintendent Decision Release from Segregation Continue Segregation Reasons: ,l Admitted to Segfor: Name of Supe?ntendenUDeslgnate (Print) Signature of Week-mate Date . Francis Noiet. Deputy Superintendent 07/20/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be condumed every 30 days) Inmate Submission . . I Superintendent Decision Release from Segegation Continue Segregation Reasons: DAY: A Name of Superi 'IendentlDestgnat Print) Signature DWI/Designate . Date . . 0 . I 7 a IL Supplementary-Raped for each Subseqttent 30 Day Period (use reverse afform for additional comments)? Comments - Superintendent/Designate Signature Date a - . - .7 521(1) 030 075400 (10:04) 000066 - Pagez. Region'al Director Review 1 . Conlinued Segregation smoned . NolSupponed - CommenIs/?m?d? Ml .o?xp (wed/1 Name of Regional DireclorlDeslgnale (Print) Signature of Regional Directorl?esignate Dale - I Supplemenlagy Report for each Subsequent 30 Day Period [g9 bottom of form for additional comments Comments Signature Dale . Mde/M ContinuedIAdditional Comments by SuperintendentlDegignate Commenls Signature Dale . A Lo< may.? Mammy g/ Organ/.4. . 4 A "to huxg? er L-Qea'rxm 23'b \wx?xVM I. - ?h {@114 s: Magyar - W4 MAW/orgy CD uuk 10' 17? 1?4 Continued/Additional Comments by Regional Director/Beggars Commanls Slgnalure . Dale - .MMIdemy 76? . *r 144/ I t? - S.NIR - I s.21(1) ?31 IOU-FL DIaldDullon: original Regional Dlreclor {Only for Regional Dlmdor Review} Copy - lnmala File GSD 075-100 (10104) - 000067 magmas WDntario Ministry of Community Safety and Correctional Services segregation Decision/Review 0' madam/0r institution . Ottawa-Carleton Dentetion Centre Name (Last, First. Middle) Client Identi?cation No. Reason(s) for Segregation 8? Protective Custody Institution Security Medical IZ?nmate Reunrest Date of Segregation 11?28-201 3 Z/inmete advised oi reason for segregation nmate advised of opportunity for Interview with Superintendent ?lnmele advised of opportunity to make oral or written submissions . mmaie waives opportunity'ior Interview with Superintendent Name of SuperintendenUDesignate (Print) Francis Noiet, Deputy Superintendent Signature Wenvoesignale Date 331?: Superintendent DeciSion rrm's section must be completed within 5 days of the inmate '3 placement in segregation) I Inmate Submission El I Superintendent Decision Release from Segregation {8?4 Reasons: Admitted in 869 for: I - Continue Segrega_iion tote,- Name of SuperintendentiDesignate Francis Nolet. Deputy Superintendent- 1! Signature of Wivesignale Date WU) ,1 with inmate to be conducted every 30 deys) I 8/53 Inmele Submission Segregation Revietl?nmale?s Segregation to be reviewed every 5 days. Interview El Superintendent Decision Release from Segregation Continue Segregation Reasons: DAY: Cqu-irsb. Name of SuperintendenUDesignate (Print) . Signature I ?ak/Bil?) Sopplementary Report for each Subsequent 30 Day Period (use reverse or form foreddr'liane! comments) A Comments SuperintendenUDesignale Signature Date . s.Nl 8.21 (1 CSD 075-100 (10104) 000068 Page 2 . - Regional Director Review 1 Continued Segregation Supported coma-1MB Nikki/(f. 4Mwa 61/50; Not Supported Name of Regional director/Designate (Print) Signature of Regional DIreclorIDesignate Date I new: . 7?7 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) . Comments Signalure - Date - i Continued/Additional Comments by Superintendent/Designate Comments Signature . Dale Sbg'. been MW . grgq'?/ 810 (MA beet?N)? 11780-17 I Out?5m- .220 431993 4 Dd-?v-er?l ContinuedlAdditional Comments by Regional Director/Designate . Comments - Signature Dale I - . . "s.NlR . 5.14gllon 5.2111) 94 min "1151"! Distribution: 0119mm - Regional" Director (Only tor Regional DirectorReMew) - Coma inmate Foe CSD 075-100 (10104) 000069 an: an Ministry of Community Safety Segregation Decision/Review it). I rec iona erv'ces '5 Ontario '3 Ottawa-Carleton Dentetion centre Name (Last. First. Middle) Client Identi?cation No, I Reasonts) for Segregation Dale ofSeyregalion i:i Protective Cuatody lnstitutio?n Security L__i Medical Ci Inmate Request 07,19,201 4 @nmate advised of reason for segregation a'lnmate advised of opportunity to make oral or written submissions Inmate adVieed of opportunity for intenriew with Superintendent . E/lnmato waiv portunity for interview with Superintendent Name of SuperintendentIDosignate (Print) Signature of Su nIIDesignale Date Francis Nole?t, Deputy SUperintendent . 07/19/2014 I Superintendent Decision (T his section must be completed within 5 days of the inmate's ptacernent in segregation) Inmate Submission - Superintendent Decision Ci Release from Segregation Continue segregation Reasons: I i Admitted to Seg for: gt} Name of Superintendentloesignate (Print) . - Signatur rintendenllDesignate Date Francis Nolet, Deputy Superintendent I 97/20/2014 Segregation Review (Inmate?s segregation to be reviewsd evary 5 days. interview with inmate to be conducted every 30 days) inmate Submission I Superintendent Decision Release from Segregation Continue Segregation Reasons: i . 6 Sit/W? M. . Name ofSuperinlendenttDesignate (Print) i - Signature of Superlnle De nate Date it) I Supplementary Report for each Subsequent 30 Day Period (use rel/arse arrarm foradditionatoomments - Comments SuperintendenUDesignale Signature I Date 91(1 CSD 075-100 (10/04) 000070 Regio'nai Director-Review Page 2 Continued Segregation g/ Supgrted A Not Supported I Comments/?m??u .?wwk, 4.6 SugML5}t;m at W1 47 p1?onij Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Dale Kiwis. Sgopiementarg Regan for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature MM?)th - My . . . ContinuedIAdditionel Comments by SuperintendenUDeng?zte . Comments - Signature Date (Liam - 619 tmwm? ?My Loam rungs/- - - . *?kf Continued/Additional Comments by Regional Director/Designate I Comments - Signature Date . 1 0 .4441 o. .504 JW c. 919?; CSD 075-100 (10104) giltgy?x - . a "v . 521(1) . . Distribution: om?wwm Diledur Roviaw) . - a' 000071 an: El 0' >Ontario @vnate edvieed of reason {or segregation 1' Ministry ?f??mmunity Saf?ty Segregation Decision/Review and Correctional Services 7/ - zero-Meat i it I I neluton it Ottawa-Carleton Dentetion Centre Name (Last. First. Middle) 0000 13 Client Identi?cation No. Re n(s) ior Segregation Date of Segregation ?otectwe CuetodL Institution Security 03/21/2014 ?edical Inmate Request Z/inmale advieed of opponunity'io make oral or written submissions nmate advised of opportunity for interview with Superintendent E?mate gives opportunity for interview with Superintendent Name of SuperintendeniIDeeignete (Print) Francis Notet. Deputy Superintendent I Superintendent Decision (This sacrron must be completed within 5 days or the inmateepracemenr in segregation) Signature denUDesignate Date - 03/21/2014 Inmate Submission - Superintendent Decision El Release from Segregation a Continue Segregation Reasons:- Admitted to Seg for: add 5 Name of SuperintendentIDesignate (Print) Signature of Sfftendenu esignate Dale cam/2014 I I Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be condude every 30 days) Francis Notet. Deputy Superintendent inmate Submission Superintendent Decision CI I Release from Segregation 8" Continue Segregation Reasons: DAY: JA Name o?wmntendenmesignete 1 I Sgpieme'ntary Report for each Subsequent 30 Day Period (use reverse arrorm for additionaicommenis} Signature of n?ntendenuoesignete Date - 03? an I4 Comments SUpenntendentlDesignate Signature Date s.Nl s.21i1i 050 amino (10104) 000072 - - Regional Director Review Continued Segregation Supported Nol Supported Page 2 .1 Eomments Name of Regional Director/Designate (Print) Date Signature of Regional DireclorlDeslgnale Wm . Katha a7 a-cr? r5: . Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments Slgnalure Date - Continued/Additional Comments by Superintendent/Desi?te Comments Signature Dale - . \?65 (M 33 00R wee/KM 61?at? zq, 2,00 (m .40 ?1 l?r men "ft-nor WU 1 V) 7 - - Continued/Additional Comments by Regional Director/Designate - Comments Signature Date ta? A l/ayM/mvmy 521(1) were) Original - Regional Director (Only forRegIanaI nectar Raid-aw) Copy tnmata File 075-100 (10104) 000073 10-. 4? of Community Safety Segregation Decision/Review and Corre ices PWE IDS-ioliu~bl Insillulion - . 7 . OttaWa?Carleton Denleiion Centre - . Name (Lasi. Firsl. Middle) CA Clleni ldenli?calion No. - Reagenm ior Segregalion - Dam of Segregauon I Preleclive Custody Securlly Medical Inmate Requeel 2-21-2014 ginmale advised of reason for segregallon . E'Tnmaie edvlsed of opportunlly lo make oral or wrillen submiselone Inmale advised of opporiunily for interview with Superinlendenl mime wa? opportunth for inlerview with Superlnlendenl Name of SuperintendenUDesignale (Prinl) - Signature olfWWaslgnale Dale Francis Nolet, Deputy SUperintendenl I Superlntendent Decision {This aeolian must be completed within 5 days of (he Inmafe?s placement in segregation) Inmate Subml eion - WM mum ?Mm??mm - 'Supen'nlendeni Decision Release from Segregaiion - Conllnue Segregalion Admittedtosegror;_W/ . Name of Supennlendenvoeelgnale (Prim) Signature of nlend UDesignale D/aie - - - Faber Francre Nolet. Deputy Superintendent r'fr Segregation Review (Inmaie'e segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission . . - s.21(1) Superintendent Decision Releaeefrom Segregalion Conlinue Segregalion Reasons: 49mm me 34 ear/?MW? . Name oiSuperi ndenUDesignate(Prini) Signalure ef Wenale Date . . . ?ame/H I I Supplementary Repert for each subsequent 30 Day Period {use reverse oHorm feraddmonaioommenrsj Commenls SuperintendenUDeel'gnele Signature Dale ~1de CSD ore-1?00 (10/04) '000074 Page 2 ?flr .Re ional Director Review . Coniinued S_egregalion Supported - Not Sapponod Commenls' ?t . NJ Mi. . Name of Raglonal DIreolor/Doslgnate (Pginl) Signature of Regional DirectorlDeslgnale I Date - Sm} lementary Report for each Subsequent 30 Day Poriod {use bottom of form for additional comments Commants - Slgnalure Dale Cohtlnued/Addi?ona! Comm'?nt?sgby SUperIntendentlDesignale Comments - . Signature - [h mmpo?? 193' (ma \oktl 4~ elf/H 11K r/ 23-0 gm?gm?p 8?14}: 02:; ma?a/Mg?. JO IL 3M0 . mama->4be 0- '1 _j ContinuedlAdditlona! Comments ionalDirector/Desi ate Comma-oh, -, Slgnalure . Copy - lnmale cso- 075-100 (mm000075 Ii Ontario segregation Decision/Review A - Ot?zge'ton De?ntetion Centre Name (Last. First. Middle) cIIaWti?cation No. Reason(s) for Segregation Protective Custody institution Security Euaa?of-Segregatlon 1 6111631 Dlnmale Request 9115,2014 - Inmate advised of reason for segregation (Emma advised of opportunity to make oral or written submissions Q?t??iate advised of ogponuntly for Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperlntendenUDesignate (Print) Signature of WWE Date SUBerimendem Decision (This section must be completed Within 5 days of the inmate's placement In segregation) Inmate Submission VContinue Segregation Superintendent Decision El Release from Segregation Reasons: . - Admitted to Seg for; MED OBS Name of SuperintendentlDesignate (Print) Signatww Dale Pat Barnes, AIDeputy Superintendent - - - Segregation Review (Inmate?s segregation to be revieWed every 5 days. Interview with Inmate to be conducted every 30 days) Inmate Submission - I If, Superintendent Decision Release from Segregation Continue Segregation Reasons: DAY: 5/ Maj dos Signature oi SupenntendenUDoaignete Date 9077 Name of SuperintendenUDe-stgnate (Print) 3??wa Supplementary Report for each. Subsequent 30 Day Period (use reverse offonn rar additionelcommanls) Comments - SuperintendenUDesignele Signature Date . 521(1) .0er (175-100 (10I04) 000076 I Regional Director Review Continued Segrjgalion Page 2 Commean 12/ Supported - Not Supponed Name of Reglonal Directo?Designale (Print) I Signature of Regional Director/Designate Date Exams ?ow 27 06? Supplementary Regort for each Subsecyent 30 Day Period (uee boltom of form for additional'comments Comments Signature - Date . Continued/Additional Comments by SuperintendentlDeslgnate Comments Signature Dale Mdelmyr \0 N5 C?s/35' 9~3b~?d I 2?0 w; 4?1&35 a ContinuedlAdditional Comments by liegional I Comments . Slgnature Dale - um: mTeaweoeD WLK Hp Fumem ow ?u 9.40 {no $00.06; .73 (20mm .0 ecu F?v Emmet ekm'mm' ego 0: a Q: Btu 5.1421(0) . . f0 F49 s.21(Dlsu'lbullnn: Original - Regional Director; (any ran-139W Dirndar Review 030 075-100 Copy - human ?le 0:04) 000077 E- i . - Minis"? Sm? Segregation Decision/Review k? . - and Correctional! Serwcee - . - . Ontario - . nos?104M - or - (awe-Carleton Dentetion Cen - - I Li Name (Last, First. Middle) I Wuncallon No. Reaeoms) 'for Segregation - Dale of Segregation metectiue Custody insiitution Security Medical Request 08,14,2014 mimate advised of reason [or segregation mm advised of oppo?unily to make oral or Written submissions _E1n?male advised ofopporluntiy for interview with Superintendent nmate We opportunity for interview with Superintendent Name of Superintendentloesignate (Prinl) SiwndenUDeaignate Date Francis Nolet, Deputy Suwiniendent . norm/2014 . I . Superintendent Decision {This section must be comprerea wimin 5 days of res inmate's placement in segregation) inmate Submission - Superintendenl'Deeision Reiease from Segregation El ConlinueSegregaiion- Reasons: - Admitted to Seg for: mam/nu! '53 95"] (vb/K44 I Name orSuperintendenUDesignaie (Print) 73mm 0 87.91% Date Francis Nolet, Deputy Superintendent 03/15/2014 .- Segregation Review (Inmate's segregation to be reviewed eveLL5 days. Interview m?m inmate to be concluded every 30 days) inmate Su?miselon . Superintendent Decision Release from Segregalion El - . Continue-Segregallon Reasons: 1: Name of Superintendent/Designate (Print) . Siande slgnaie Date MMF .13 I - Supplementary Report for each Subsequent 30 Day Period (use reverse offom'i for additionaicommanis) Comments SuperintendenUDeeignete Signature Date . - . . - 21(1) - GSD (10/04) I 000078 ,Reg?ml Director Review Page 2 Continued Seggegation 7 E7, Supported NolSlonrted Comments - W71 ?Va MM Nama of Regional bilgclorlDeslgnate (Pnnl) Signature-0f Regional DIrector/Daslgnale Dale 0 7? ti, 02?? S?pplementary Report for each Sub?uent 30 Day Period [use bottom of form for additional comments . - Comments Slgnalura Date Mde/M A Continued/Additional Comments'by 'SuLerintendenHDesignate Comments 7 . Signature Dale . ~100er inf '14 lf?undch?kl; [0 m?kaa ya r3 L4 L0 wag?. 1} 12/ Continued/Additional Comments by Regional Director/Designate . . . Comments . Slgnalure Dale i s.21(1) Original - Regional 01mm 075v100(10:04) - (Only (?Regional Direan Rev!an Copy - Inmate Flla 000079 Eame?a?eua I . 7 . ?J?f?tt? Minister of Cemmunllv Safety Segregation Decision/Review IO and Correctional Services .n ar - ingronqwr . OttaWa?Carleton Dentetion Cen Name (Last. First. Middle) Client Identi?cation No. 7 Reasonis) for Segregation i Date of Segregation Protective Custody Institution Security Medical Inmate Request 08,14,2014 anrnate advised of reason tor segregation DJnmaIe advised of opportunity to make orator written submissions Dlnmate advised oi opportuntiy for interview with Superintendent Inmate waives opportunity for Interview Min Superintendent Name of SuperintendenUDesIgnate (Print) Signature or Super] landenUDeeignate Dare Francis Noiet, Deputy Superintendent I 0871412014 . I . Superintendent Decrsron (This section mast'be completed within 5 days of the inmate?s ptecemerrt in segregation) Inmate Submission (2 Superintendent Decision Release from Segregition Er Continue Segregation Reasons: . Admitted to Seg for: misconduct Name of SuperintendenilDesignaie (Print) Signature of?W Date 08! 15/2014 Francis Nolet,? DeputiSuperintendent Segregation Review {inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision [3 Release from Segregation Continue Segregation Reasons: - - I ngum - Name ofSuperintendenttDestgnate (Print) I SlgnetureoiSu nnEndentlDesignate Dale - ai?otm? . - - Supplementary Report for each Subsequent 30 Dayjeriod (use r3verse otiorm for additional comments) Comments SuperintendentIDesIgnate Signature Date 5.21 i s?21(2?? 050 075-100 (10104) - - . - Regional Director Review Page 2 Supported Continued Not Supported g7 Comments .MM gum/:14. 4 WA. W74 Name of Regional Directormesignate (Print) Signature of Regional DlrectorlDesignato Date SupElemeniary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments . Signature Date Continued/Additional Comments by SUperintendent/De:signate Comments. Signature Date . I 0 Down WeLf\/ {Mag I ?t?f 50 awn WMNA Jun-3w reitqu Itrum-k g/guM - V, (J (An '14 . Continued/Additional Comments by Regional Director/Designate - - Comments Slgnature Date . 29/ 5/ . 5 ?41+ - mamnuuon: Originai - Raphael Diredor (only forRagfonal Direuor Roiriaw) Copy Inmate File 030 075-100 (10104) 000081 til-HEW Segregation Decision/Review- imaroriu ~01 9' Ontario 0000 Name (Last. First. Middle) Client Identi?cgwh No. Reagents) tor Segregation - - 29 0m ?0 if? 4? figs Date oi Segregation Protective Custody institution Security Medical inmate Request H66 15 10 sept 2014 inmate advised of reason for segregation inmate advised?oi opportunity to make oral or written submissions Inmate advised oi opportunliy tor Interview with Superintendent inmate ?vanes opportunity for interview with Superintendent nale Date Name of SuperintendenUDesignaie (Print) Signature oi Sup Piouffe 10 Sept 2014 Soperiniendent Decision (This section must be completed within 5 days ofthe Inmate's pie emgnt?n segegarran) inmate Submission - . Superintendent Decision Reiease irom Segregation Continue Segregation Reasons: . We) db 9 - Na?oi SuperintendenuDasignate (Print) Signature of SupejntendenUDesignale Date (gilt? e. Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmete to be conducted every 30 days) inmate Submission . . Superintendent Decision Release from Segregation Ci i Continue Segregation we - a 6?05 Name of SupenniendenUDeaignaie (Print) Signature of SupenntenoanUDesignale Date - - i _Supplemeniary Report for each Subsequent 30 Day Period (use reverse affarm additionaicomments) Comments Superintendent/Designate Signature . Date MMIdd/my . I i_ i i s.21(1) (330 075-100 (10104000082 Regional Director Revlew Page 2 El? Continued Segregation Supported Comments . Not Supported dye/ewa _ery( Wag? Name of Regional DirectorIDosignate (Print) Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date ContinuedIAddlilonal Comments by Superintendent/Designate Comments Signature Date I L0 N15 (ADS A 19 I Mics 90$ 513? 10 003ALAS lo - .5 - - "ll/'2 3?0 mev bylaws/1. Continued/Additional Comments by Regional Director/Designate Comments Signature Date .Mw/r?az 01m May 5? A?Mwe/ 14rd?: {Id l/t/ f4! 4:74111/044: DOIC (Kip 09V :2 14mm? 1-1 I s.21(1) 5.21m") CSD 075-100 (10I04) Dlalnnuuon: anginat - Regional Director (01w (orReglona! Ram'qu Gap)! - [Male Filo 000083 Mir? Ontario Segregation Decis'ioaneView .0000 a in-Io~m~or I Name (Last. First. Middle) Client ld? uni?cation No. Reason(e) tor Segregallon I fade. . Protective Custody I: Institution security Medil Inmate Request ?6154 f1: Lil/I MED. 4'1 0410' Date of Segregation 13 Sept 2014 E. inmate advised of reason for segregation Inmate advised of opportunity for interview with Superintendent E-lnmate advised I Inmate waives of opportunity to'make oral or written submissions Jpportunily [or Interview with Superintendent ntendenUDesignale Name of SuperintendentlDesignale Signature oi Sumr-MWMenUDeei nete Date Plouffe i 13 Sept 2014 __Superintendent Decision (T his section must be Completed within 5 ms of the infnete's pie segregation) I Inmate Submission -- juperinlendent Decision Release from S_egregall0n Continue Seg?gatten Reasonsz. Neg; Lac \7 kat,? Name of SuperintendenUDesignale (Print) Signature of Super Date 4 war?z if Segregation Review (Inmate's eegregelren to be reviewed every 5 days. rnrerview with I Inmate Submleeton 12". We to be conducted every 30 days) Superintendent Decision Release from Segregation Continue Segregation H11 I Restraint?) Lu.)ij UVJE-I Name of SuperintendenUDesignete (Print) Signature of Date 4 [oh/71 . I I . Supplementary Report for each Sunsequent 30 Day Period (use reverse or form rcroddmonarcommanrgL - Comments - SuperintendanUDeslgnate Signature Date . 5-6414le 1 . Page '2 Regional Director Review Continued Segrogiion Supported Not Supported 'Comments . . . . -- Queue Name of Regional Director/Designate (Print) I Slgnature of Regional DHectorIDesignale Date Supplementaty Repar't for each Subsequent 30 Day Period (use bottom of form for additional Comments) Comments Signature Date - Continued/Additional Comments ELSupe?ntendentlDeitgnate Comments Signature I - ?Dato . Io Leacuinlv-xb twwa XS hqu 9'3? ?l?f C) . I 92> meet: I ID 25'. m?weqlewmj 1- [j 7 30 .rLQ-srlmAny on}? Lemmy/:4 V101 23 2 . - ContinuedlAddittonal Comments by Re?ned Director/Desi nate Comments Signature Date MMIddIyny 5 14mm; ?"521 (1) Dismbutton: ?nginat - Ragimat Dim-ow [Only lor?ogional wedor?avion? . Copy Inmate File 0er 075?100(10104000085 mew.- Ontario Ministry of Com and Correctional HO lnsti ttewa-Carleton Dentetion Cen Segregation Decision/Review CM u~o . Reasonts) tor Segregation CI Proteotnre Custody nstitution SecuritLD Medical CI inmate Request Name (Last. First. Middle) Ilent Identi?cation Ito. Date of Segregation 09/1 0/201 4 Q?Iamate advised of reason for segregation advised of opportunity to make oral or Written submissions ?nale-advised of opportunity for Interview with Superintendent Inmate waives _opportunity for interview with Superintendent N??e ofSuperintendent/Designate (Print) Signature or SuperintendenUDesignate Dela Sebastien Cote Superintendent Decision {This section must be comprered within 5 daze or the inmate 's placement in segregitionj Inmate Submission . Superintendent Decision Ci Release tram segregation Continue-Segregation Reasons: Admitted to Seg for: LN fur/an Signature of SuperintendentIDesignate Date Name of SupenntendenUDesignate (Print) Pat Barnes. AJDeputy Superintendent ?Seg regation Review (Inmate 's segregation to be reviewed every 5 days. interview with inmate to be conducted every .30 days} Inmate Submission 6/ Superintendent Decision Cl - Release from segregation Continue Segregation I . Reasons: DAY: Na Supenntendentloesignate (Print) Signature of SuperlntendentlDesignate ?LMtf Date (iv/5?4? Supplementary Report for each Subsequent 30 DeLPeriod (use reverse or form for additional comments) Comments Superintendenlloesignate Signature A Date . ?can 075.100 110/04) 000086 . Regional Director Review Continued Segregation Not supported ?Pa-gez (23/ Supported Comments AA - Um fa {7 Name of Regional DirectorlDesignate (Print) Signature of Regional DirectorfDosignate Date . K?w'ug Kan - (5- crof? if ?upptementerweport for each Subsequent 30 DgPeriod (use bottom of form for additional comments Comments Signatune Date i ContinuedlAdditional Comments by Stgenntendentlbesignate Comments . Signature Date . 1p 4' 29> if mksuwnihc} 333t? f?J?Q?a/M/j/rf Gigi/AM to - Continued/Additional Comments 9/ Regionat-Director/Designate - . I Signature Date Comments 5.Dial?bu?on: Original Regional Director {Only for Regional Umr??aw?aw) gap}! - inmate F?o 000087 CSD 075-100 (10/04) - Ministry of Community Safety and Correctional Services lbw-v 4. 3" Ontario Segregation Decisioaneview tinny i 04 Lie- to; . lnstiluti I wa-Carleton Dentetion Centre Name (Last. First, Middle) rReasoMs) for Segregation Protective Custody institution Security edlcal Inmate Request Client Identi?cation No. Dale of Segregation 07/ 1 5/2014 [j mate advised of reason for segregation I I In mate advised of opportuntiy' for interview with Superintendent mnmale advised of opportunity to mal're oral or written submissions inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Supe dentl signate Dale Francis Noiet. D?uty Superintendent . I 07/15/2014 I . Superintendent Decision (This section must becompieted within 5 days ortne Inmate?s placement in segregation} Inmate Submission I - - Superintendent Decision Release from Segregation Continue Segregation Reasons: Admitted twin/wa? ML - Name of Superintendent/Designate (Print) Signature of Su en asignaie Date Francis Noiet. De?iy Superintendent 07/15/120? I . Se grgqation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to he conducted away 30 days) Inmate Submission 8? Continue Segregation Superintendent Deoision Release from segregation Reasons: 7 DAY: mm (twee/W MW, Name of Superintendent/Designate (Print) Signature perintendenUDaslgnale 'Date . own-M . I Supplementary Report for each Subsequent 30 Day Period (use reverse arrorm tor additionatcommantsi Comments Superintendent/Designate Signature Date . -- MMIddIyyw s.21(1) r" 080 075100 (10t04). 000088 ?Regional Director Review Page 2 Conlinued Segregilion S-uppo?ed Not Supported Comments if a . J27 M55 o?wwm . Name of Regional DireciorlDesignata (Pginl) Signature of Regional DirectorIDasignala Dale Slipplementary Rggori for each Subsequent 30 Day Period ?tse bottom of form for additional comments) Commenls Signature Dalo _l MMld?rm Continued/Additional Comments_by 'SiperlntendenUDgsiJnaie Commenla - Signature Date MMIddImr obs ?7t2 tvx1L4l zakgs 7( 'obS 30 inc?e:ka ?paJ )57deloaj - Continued/Additional Comments by Regional Director/Designate -- Comments .- - Signature Date tame Momma) not) is T. (know Satan?mo.) ngu??o I LIB. Tun-5- imo?k' w? ?Wt??a?b 6?1 451/? '?hf Inmate or gimme-amt. rate we Am?mcs #521?) ?m ld'??lV - I . - Dlalribtllinn: Original - Regional Director (Onmeregianei Diracror Rovlaw) Copy - Inmate File CSD 075-100 (10104) 31 000097 Regional Director Review i Page 2 Conlinugd Sggregauon oned Sgyported Commean 0?4lUC-xa? 7461-49? 52/1/ij plum!? Name a! Regional Directorfbeslgnal? Emu Signnlum olRegianal DImdorlDeslgnate 75am Ky BMIS 6' ch' Hf; Supplemenl? Repon for each Sabsequenl 30 Day Period (use boitom or form for add/flo?commenis Gommehls Signalure Date 1.1de ContinuedlAddilionai Comments by Suge?ntendentloeslgnate . Commems Signature Dale SpuuA/h nix?tment? . Io?n" 1% 5.21 (1) ContinuadlAddiliona! Comments Direclo?Designale - - Gammon?: . - slannEure We Mded/ym $141. I - xgg?m gm; l/ I - 31,96th 3% 4:40 11? 665'! km: 4.1m jar: m? Wu?m cys'mu'uw Rae-gm gm Ida-2L db- 91C MML- Um a rt. ?eaJ?w Fir Seawa?i Oltmbuvw rim-Mimi: mm menu Workma??m 1-5415 1.4? Cos-y-lmr-Inftta Hind TM LMNC . i (f 4 C30 075-100 {10104) 2% . 000098 ?5 . Page Regional Director Review Conllnued 3993mm Supported ET No! Sgpgo?ed Cn'mman . . Name of Re?iml Dimdormeslgnale of Regional DIreckorlDeamnato Daia Supplemental]! Report-for ?ach Subsequent 30 Dy Period (use bottom of form for additional comments Comments SEnalura' Dale Mde/nm 321(1) ?1 . . si?ziifi Continued/Additional Comments by Superintendent/Damgnate I .1 - - - Comments . Signnlure . Dale . - A Mwaamr 453? Pad (lym{ 01411 a: g" J4 - 3*pr QEEAH: Snub :gk A 13'? Mh?r am, 7 I ,Lno ?Sew? A 9/ ?13 v/c/ . - . . - HTS \ivwsx I at As" J?l? ,3 LNG re.me 9A \nrw1_uwf9? Taco rx'L' ContinUedlAddllional Comments b?jggion'al DirectorIDesiqnale - . commonm I - . Signaling: Dale - cm? 11/4 . . . I mum: gamer ?12; (Am? j?/f?ldi/JA ??tAtL W- M2645 wig- C?tvufu 444% . I O'Oq?vy I . . gm D'umbuunm ?Odan - mg'mn I:qu (buy?I'al?ophnam?eemr Ra copy dam? Fun .030 015400 (10104} I I _000099 Segregation Decision/Review Ministry of CommunriE ., - and Correctional Se a: . V20ntarlo a i we; ecu - Warm Dentetion Ire Name (Last, First. Middle) Client Identi?cation No. . . Reasonts) tor Segregation - - Date of Segregation ?motectwe Custody Institution Security Medical Inmate Request 09,07,2014 Inmate advised of reason tor segregation - advised of opportunity to make oral or written submissions El We adViBEd ofobPOflUnliwor inlerview with SUperintendent El Inmate waNee opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of Superint antIDeeignete Date - 00? ?0al 4" I Superintendent Decision [This section must be completed within 5 days or the inmate's placement in segregation) Inmate Submission e/ Superintendent Decision Release from Segregation? Continue Segregation Reasons: Admitted to Seg? for: o? Mam Name ofSuperintendontIDesignate (Print) I endonllDeslgnate Date Pat Barnes. NDeputy superintendent I Se re ation Review [Inmate?s segregation to be reviewed every 5 days. Interview wan inmate to be conducted every 30 days) Inmate Submission . . SUJJerintendent Decision Release from Segregation Continue Segregation Reasons: DAY: 5 (144/ Pawn i Name ofSupenntendenUDestgnate (Print) Signature ofS rintendonUDeeIgnate Date ?mr' I ?1 Supplementary Report for each Subsequent 30 Day Period (use reverse ortonir foradditionelcomments) Comments SupenntendentlDesignate Signature Date - - C5D 075-100 (10104) '000100 Regional Director Review Continued Segregation VSupgorted Page 2 I Not Supported 420w . WM We Tame of Regional Dl?dorlDesignale (Prinl) Signature of Regional Dlreetorloesignale Dale ?u Sugplementary Regan for each Subseggent 30 Day Period (use bottom of form for additional comments Commenls Signature Date Continued/Additional Comments by SuperintendenUDesjynate Comments Signature Date mo 22451 [Leaww*1 . 4~l1~if \ig - Du)? . 9- 233']? l? I Omh' a ED Wm Vega-j" . '15?7?14 L. - . . . Continued/Additional Commenteby Regional DirectorIDesignate Comments - Signature Date I MMIdd/?yy ugun?h m?ERwu?n?? Aw) 4? Wmop on; 'Uiit'T was . Y?U?Ujm-?o?lft -quu- (MGM 3.149440% - 7 - 52112)?) - Dlaltihullun; Original - Regional Director (Only for Regional DirectarRom?uw) Cooy - Inmate F?o 050 075-100 (10104) 000101 a - ?Segregation Decieraneview - . . I A??utullon f3 0000' Name (Last. First. I I . No. - Reason(s) for Segregation i Date of Segregation Protective Custody Security Medical inmate Request I: Inmate advised of reason -for segregation [j Inmate advised of opportunity to make Oral or wrillen I Inmate advised oi opportunity for Interview with Superintendent Inmate waivg??ppdl?mly tor lmlew with Superintendent Name of SuperintendenlIDesignale (Print) Signatur erln n?en gnale Date I OM Oliver A r- . 5 Sep 2014 Superintendent Decision his section must be completed within 5 days of the inmate's placement In segregation) Inmate Submission - _S_uperintendant Decision Release from Segregation Continue Segregation Reasons: . I JUN Out! I '7 Name of SuperintendenUDeslgnate (Print) Signature of SuperintendenUDesignale Date :p'?qw . 01rth I Segregation Review Janete 's segregation to be reviewed every 5 days; Interview with Inmate to be conducted every 30 days) Inmate Submission . ca/ Superintendent Decision Release trom Segregation Dw- Contlnue Segregation . b, . Reasons: My Name of SupenntendenUDesignate (Print) SignathUOeslgnale Date If) l?jf Supplementary Report for each Subsequent 30 Day Period (use reverse arrorm for add?ionelcomments) Comments A Superinlendentloeslgnate Slgnature Data . . c: 91(1) CSD 075-100 (10104) 000102 hv?r ., ,1 Regional Director Review Page 2 Continued Segregation [31 Supported El Not Supponed -. Comments Hap; OJUKI Name 0! Regional Dlre morlDeslgnale (Print) Signature of Regional Directorloesignale Date tithe/va 4014-771 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - - Commenls . Signature Date Continued/Additional Comments by SuperintendentlDestgnate I . Comments Signature - Dale ?0 [ng I [If (Lam ?5 r3715!L ?3'3077 A - 30 4 3? (Mn' 35?3"? ContinuedlAddittonal Comments by Regional Director/Designate Commenls Signature Date? MMIdd/yyw 1MWM {(0207: luv {aim?v?Z/?a m? Cgawtr Z. uz/?l $0 mm S.NIR 521(1) 06 acT'id'K/ .5 I Original - Regional mm n'reaturRava'ow) Copy - Inmate File CSD 075-100 (10I04) 000103 Sm.- 5- and Correctional Services -- . Ministry ofCommunitv Safety VI Segregation Decision/Review Ontario miter. . Ottawa~Carleton Dentetion Centre I - Name (Last. First. Middle) . Clienlidenti?cation No. - Heaeonts; tor Segregation - - . . Date of Segregation- Ergrotecttve Custodg institution Security Medic?ai CI Inmate Retmeet 06(0712014 BTnmala advised oipreason tor segregation I was advised oiopponuniiy to make oral or vvritten submissions inmate advised of opportunity for interview with Superintendent Inmatempponunitmr interview with Su erinlendenl Name 9f Superintendeniioesignate (Print) I SignalWeQ?x Date Francis Nolet, De?ty Sgperintendent . 08I0712014 Stygerintendent Decision (This section must be completed within 5 days of the inmate's placement in segogation) inmate Submission Superintendent Decision Reiease from Segregation - Continue Segregation Reasons: Admitted to Seg tor: Mt?d?ptx? Name of SupenntendenUDeeignate (Print) . enUDesignate . Dale Francis NoleLDepuiy Superintendent . Segregation Review (inmate'e?gregation to be reviewed every 5 days. Interview with Inmate to be conducted every 30 dalqu Inmate Submission 9/ Superintendent Decision Ci Releaseirom Segregation Continue Segregation Reasons: . I rayon? Name of 25? tendenilDeelgnatetPrint) Signatureo intendenUDeeignale Dale - 7/ Supplementary Report for each Subsequent 30 Day Period (use reverse offann foredditIOnal comments) . Comments SuperintendenUDesignaie Signature Date 030 075-100 (10104) 000104 . s?Re'gionaI Director Review :Go?ntinued Segregation ,i gornh'ienls. I Page 2 Supported Nol Supported ?og M51 ?gment Regional DirectoriDesignate (Print) Signature of Regional DirectorIDesignate Date I jar-V: . I I - Lajffiif?f? - ith-g. - ?4 - 6? 1'4" Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . .513: Comments Signature Date 'i?ontiripedIAdditionai Comments bLSuperintendenUDesignate . . . Comments . Signature Date .: A - I I (wme . 3min - q-ii-"lLi - 7 I 40?} ("Lapin/Lt ?i-liL-?mi - woo ?oor/i; Ujgini-?S-emr?k? - to Hit Lo. Soc/Wok" .- Con_tinri6diAdditionai Comments by Regional Director/Designate Comments Signature Dale AM) DAIMA mm Momma/uni with Me S?cdb??emmdt Uemk W?mssmur auth- - _s.NlR s.21(1) 0 6 i501 2019 7 . Distribution: original - Regional Director (Only for Regional Directornoviuwj . Qapy - inmate File .- . 1? CS?Di?uisyrodhtiomi - A ?000105 ?Manna . - Pagez Jietglonal Direcjor Review Conllnued Se 3 - Commanla gr an on 8%me NoIISupponed wt wk 7 94 Nalna of Regional DltodorIDlegnnle (Print) of Reglunal OlfodorlDesignale Dale . I Supplementary Rgport for each Subsequent 30 Day Period (use boltom ofrorm for additional comments Commelila . Signalman - Dela . Continu?dIAddillonal Cmems lay Supennt?ndenUDengnale I Commelfls Slgnalum Dal: . . A 3( . Mdeer 5w: y/ . ?lO (Ari-.1 I I I . ?7I4(2)(on 97. {p .21 1 21:21an? wk?: I . lbw/L 3% 51> lo zen-1ConlinUadIAdditlonal Comments tly Regional Director/Design Commenls Dal: MMIdd/Wyy (mv mic; mo; album?qu ?an [1-5 (trunk ?g fab-? ?auntk 06 ?120(9- 'menk?, ll? ULT 6W 0.7 a Dl?l?bullom Odo?Mal ch'nll? [armohw wad?, Copr~lnma aFDo cso 075-100 (10104) . dq- vaCT-g 24/? 000106 Segregation Decision/Review Minlet Ontario - Ottawa-Carleton Dentetion Ce?ntre Name (Last, First, Client Identi?cation "Reason(e)rlor Segregation i 7 Date of Segregation Protective Custody Institution Security CI Medical Inmate Request 08/06/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions . Inmate advised of opportunliy for interview with Superintendent El Inmate waives opportunity for interview with Superintendent Name of SupenntendentlDesignate (Print) Signature of Smte Date . W39th . - - 'OTI/otn/u?f Superintendent Decision (This section must be completed within 5 days oflhe Inmate's placement in segregation) Inmate Submission . SUPE?ntend?nt DeCiSion CI Release from Segregation 12"" Continue Segregation I Reasons: - . . - Admitted to Sag for: Name of Superintendent/Designate (Print) . Signature of SuperintendenUDeslgnate Date Pat Barnes, AIDeputy. Stip'en'ntendent . A f) ~5 I Segregation Review (inmate's segregation to be newwa every 5 days. Interview with inmate to be conducted eVery 30 days} Inmate Submission. . t! Superintendent?Decision Release from Segregation Continue Segregation Reasons: kid Name of SuperlntendentlDesignate (Print) SignatWeslgnate Date [pi/Enme I Supplementary Report for each Subsequent 30 Day Period (use reverse offarm for additional comments) Comments I . Date - I 21(1) - _4 (250075-100 (10/04000107 Regional Director Review Page 2 Continued Sggiggallon Commenla Supponed A El . Nol Supported Tame of Regional DireciorIDesignale (Print) Slgnalure of Regional DlreciorlDeaignale Date Wig Kaine??2. . dcr/y SupplementarLRegort for ?ach Subsequent 30 Day Period ?59 bottom of form for additional comments . . Comments Slgnalure I Dale Continued/Additional Comments by SgperintendentlDesiqnate - Comments Signature Dale . . gr ,1 - - . 3 mum/M (o 40 Mon/mm W?Ld-quoq - 20' ?l 9 mmwwebuek~ wardq Madman 3-50 )3 ALJIJ {km/CW 5' ?i Continued/Additional Comments by Regional Director/Designate Comments Signalure - Dale _j Him?; UV 'mg; (S ?52 a; ?zazumz '5 km?, we ?ZioL fer a (PM (PKCUAU 51/191 5 LL Qb ?ac,"rl- 74W I rr" xix Distribull on: Original - Regionai Dilech (OW for Region! Dfrador Renew) CSD 075-1 00 (10/04) Copy - Inmate 000108 . fr), I Segregation Decision/Review. mf?' A - ins' /?::v::arleton Detention?t _Name (Last. First. Middle) 7 Client Identi?cation Nt/ i HOBSOMS) tor Segregation Date of Segregation . 05/07/2014 Protective Custody Institution Security Medical Inmate Request Inmate advised oireasonfor segregation . Inmate advised of opportunity to make oral or written submissions inmate advised of opportuan for interview with Superintendent . Inmate waives opportunity for interview with Superintendent Name oi SuperintendentiDeelgnate (Print) Signalur perintendenUDesignate Date Mr. Frank Nolet 05/07/2014 Superintendent Decision (This section must be completed wiihin 5 days of (he inmate's placement in segregation) Inmate Submission I We WM We Superintendent Decision Release from Segregation El Continue Segregation ReasonsSignature ofSqunate Date . Mai/e . 00?er Segregation Review (Inmate's segregation to be reviewed every 5 days. interview wiih inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision Release from Segregation 8? Continue segregation Reasons: Amy Name of??ntendentl?esignate (Print) Signature ofWesig?-?ale . Date I Supplementary Report for each Subsequent 30 Day Period (use reverse afform for additionalcommenis) I Comments SuperlntendentiDesignale Signature Date . sj?ii) 060 075-100 (10104) 000109" Regional Director Review Page 2 Continued Segregalion - W/Supporled Nol Supponed Comments . Name of Regional DireclorlDeslgnale (Print) .Signalune of Regional DIreclor/Designale Dale '6 Suoplementary Report for-each Subsequent'30 Day Period (use bottom of form'for additional comments Commeme Smnmum - Dam Continued/Additional Comments by SuperintendentIDesignate - . Comments - Signature Date :25 mic?2'43 hum oujs TD ?\Ut\3 UIMA . 9' Bf rogkgm) q? 7? [Lb irzc?k?r?um) 1/3 was? \in: \er?3r 7' my Mum?s ?nuke Contlnued/Additional Comments by Regional Director/Designate . . Sbnmuw Dam 'HlAnTt': b15096 a?Mh by ?v SEC uMT'tw 3: 6w sum/l Mead? 1% 53:01.. 74M - . c: 14(9)(d) . .211 $.41izm) 7' - I Original - Regional Dirncgor (Only forRegiona} Director Review Copy - lmnau: File (:50 075-100 (10104) 000110 II .. I ?Fm? Ministry and Co Ontario ?a Segregation Decision/Review institutio Ottawa-Carleton 'Dentetion Centre Name (La'st. First. Middle) Client Identi?cation No. Reason(s) for Segregation El Protective Custody institution Security Medical lnmale RE:un Date of Segregation 1-8-2014 ig/?ymate advised of reason for segregation inmate advised or opponunty for interview with Superintendent mmate advised of opportunity to make oral or written submissions El?lnr'nate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Francis Nolet. Deputy Superintendent Signature of SuWnUDesignate [git/18,1! I Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) inmate Submission Ate, mat/om?; SUperintendent Decision Release from Segregation Continue .Segr_egalion Reasons: Admitted to Seg for: Incompatible 1.3? Name of SuperintendenUDesignate (Print) 1 Francis Nolet. Deputy superintendent Signature of SuWogqignate Segre gation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) E2 8/ u/ Inmate Submission - Release from Segregation SUperintendent Decision Continue Segregation . Reasons: Meant/385% . .. (Print) Signature of-Wenmesignale - Date - Newt - Jam 43/14 Supplementary Report for each Subsequent G0 Day Period (use reverse oftorm foradditionatcamments) . Comments Superintendent/Designate Signature Date - - s.21(1) CSD 075-1oo (1'0104) 000111 .- I - Regional Director Rewew Page 2_ Continued Segregation Supported Not Supported Comments - ?/xomrr?r 4mm 7L: Cnig gt haw-k 0/3 Name of Regional DIrectorIDasignale (Prinl) Signature of Regional Director/Designate Dale K. 6 064"? Supplementary Report for each Subsequent 30 Day Period (use-bottom of form for additional comments . Comments Signature Date Continued/Additional Comments by Superintendent/Desig?tte Comments Signature Date . A *uhchike?517.9 m? Continued/Additional Comments by Regional Director/Desiggte - Comments Signaluro Date tuner: I wrme AND we (zen/yer I we; mun.? ms/x-. (mm kic- ?Wiwbn (a MOM. whim? ileum/M9 um rte if am, Sui-2454?. m, MW - . 4 1521(1) L, . Distribution: Original - Regional Dlredor (own: Regional awor?owem Copy - Inmate Fnla cso 075?100 (10/04) 1 000112 ?air: - Mg?'ztgrof Safety Segregation Decision/Review - . - a ec a ces f? Ontario - AXE - on Off/(9W4! . Ottawa-Carieion Denletion Centre) Name (Last, First, Middle) i Client Identi?cation . Reasonia) for Segregation El Protective Custody Mluiion Security Medical Inmate Request Date of Segregation 09/03/2014 inmate advised of reason for segregation Inmate advised of opportunin to make orator written eubmissions Inmate advised ofopponuntiy for interview with Superintendent Ci inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendenuoesignale Date 09/03/2014 Superintendent Decision (This section must be completed within 5 days of the inmate's ptacement in segregation) inmate Submission - Superintendent Decision Release from Segregation 43' Continue Segregation Reasons: Admitted to Seg?forzl ?tguMTK Name of Superintendent/Designate (Srini) Signatur SuperintendenUDesignato Date Pat BarnesI AIDepUty SUperintendent 09/04/2014 Segregation Review {inmate's segregation to be reviewed way 5 days. Interview with inmate to be conducted every 30 days) inmate Submission 7 I Superintendent Decision Reieaseirorn Segregation Continue Segregation Reasons- ?at/?1K 'Name of Superintendent/Designate (Print) Sign Superintendent/Designate Date ;0 - Ci -- IV Supplementary Report for each Subsequent 30 Day Period (use reverse afform-foraddltionat comments) Comments Superintendent/Designate Signature Date ??iid) 521(1) 050 075-1 no (10104) 000113 r/ Regional Director Review Continued Segregation Comments Supported Page 2 El Not Supported Name of Regional DirectorlDesignale (Print) Signature of Regional DirectorlDesignale Date Supplementary Report for each Subsequent 30 Day Period (use bottom offorrn for additional comments Comments . Signature Date - Continued/Additional Comments by Superintendent/Designate Comments 2. =5 Signature Dale Mum pruwt 0,00.1 Slugger-1 I mgr-M 2.5 (July 044m A Q-er/g/ 5; Dw? Continued/Additional Comments by Regional Director/Designate . Comments i: - Signature Date MWJJ ?-rv - @jjaM 3/20 A . - 5.21m 030 075-100 (1.0104) Original Regional Director (Only (or Regional Director?eviaw) Copy - Inmate Filo - 000114 i - i 'on/Review ., )0 . and Co" egatron Decrsr ntarlo - . Ottawa?Carleton Dentetion Centre? Name/(Last. First. Middle) Client ldentilicationi:/ sonts) for Segregation Date or Segregation gProteottve Custody Einstitution Security CI Medical Inmate Request 06-10-2013 gmato advised of reason for segregation [j/l ate advised of opportunity to make oral or written submissions . inmate advised of opportunity for interview with Superintendent D/IrTnTate waives opportunity for interview with Superintendent Name of SuperintendentIDesignate (Print) Signature of man D'esignate Date I Francis Nolet, Deputy SUperlntendent' I 06-10?2013 Superintendent-Decision his Section must be completed within 5 days of the inmate?spiacemant in segregation) Inmate Submission . . 1 Superintendent Decision Release from Segregation Continue Segregation Reasons: . Admitted to 899 for: security concerns - Name of SuperintendentIDesignata. (Print) . Signature of ri tandem/Designate Date Francis Nolet. Deputy Superintendent Sikh l3 i Segregation Review (Inmate's segregation to be review/ed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision Cl Release from Segregation - . I Continue Segregation Reasons: DAY: .. 5 (- Name oiSupenntendenUDesignate (Print) - . Signature Waignale Date <5 (Etna/a. Nate/k - Joints/W3 I r_?Lr4pptementary Report for each Subsequent 30 Day Period (use reverse offarm for additional comments) Comments I SuperintendentIDesignate Signature Date 521(1) 030 075-100 (10104) 000115 Page 2 ,4 Regional Director Review - Continued Segregation Supported Not Supported Comma?? . Name of Regional DirectorIDesignate (Print) Signature of Regional DirectorIDesignate Date - 5a 0 an 254 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments Signature Date ContinuedIAdditionai Comments by Superintendent/Designate . 7 . - Comments Signature . Date 455? re?ex} (mm ad ?Se g?gr i . . - 3'60 toga? \mm ?Seguph . . 3 - - ?llaS wilgta \gut?vk Wk} om, 7y I uml? r?Sew? 9/ my a Li'l?S rem?; \tvtv'?? I Peek? nos) lufka Uhnl?? 'Sec?Q m4 Continued/Additional Comments by Regional Director/Designat A Comments Signature - Date (D I AW Se - g/pg521(Distribution: Original - Regional Director {Only for Regional Director Review) Copy - Inmate Fun CSD 075-100 (1DIO4) 0001 16 -. a Segregation Decision/Reuiew . A. A. Ontario institution r/ ococ Nam-e (Last, First. Middle) CliantW?oation No. . Reasonts) for Segregation Date of Segregation Custody institution Security Medical Inmate Request 2 sep! 2014 inmate advised of reason [or segregation - . inm'ate advised 0i opportunity to make orator written submissions inmate adirised of opportunliy for Interview with SUperintendent Inmate waives opportunity for intervlew with SUp?erintendent Name of SupenniendentiDeslgnata (Print) Signalure of SuperintendenUDesignate Date Piouffe - . '2 Sept 2014 Superintendent Decision {This section must be oompieied within 5 days of the inmate's placement in segregation) Inmate Submission 5 Superintendent Decision Release from Segregation Montinue Segregation Reasons: Name Signatur ofSuperintendenU signate Date kw, c? I segregation Review (inmate ?s segregation in be reviewed every 5 days. interview with inmate to be conducted every 30 days) I Inmate Submission . 9/ Superintendent Decision CI Release from Segregation I Continue Segregation Rea ns:_ Na SuperintendenUDeslgnate (Print) Signature erintandontlDesignate. Date Ibo] Supplementary Repert for each Subsequent 30 Day Period (use reverse offarm rar additional comments) Comments - SirperintendonUDeslgnate Signature Date . . s.NiR s.21(1) - CSD 075-100 (10104) - 000117 Regionel Director Review Page 2 Conlinued Segregation Supported Ci Not Supported Comments reggae/{MM OWL (Mm M?wwj New; CSD 075-100 (10104) Name of Regional Direuormesi?nate (Print) Signature of Regional DirectorIDeslgnate Date i Kr Beams i .ocr MC Supplementary Report for ea'ch Subsequent 30 Day Period (use bottom of form for additional Comments 7 Comments Signature . Dale Continued/Additional Comments by Superintendent/Designate Comments . -- Signature Date . /i ?ouw?j 7 Ci" ?ewkax r\/LSeww?. 9" I, - 3? Continued/Additional Comments by Regional Director/Designate Comments Signature Date, . . 3e 1/396594/4 PM 04% Ll 1AM M, 4.9.5691.s.21(1) . 21 Diemnullnn: 000118 I Minis"? O?C?immun'ly safety I . Segregation Decision/ReView Ontario and Correctional Services ?ue/044 ?0i Institution I - I Ottawa-Carleton Dentetion Centre" Name (Last. First,.Middie) 020V 125 No. Reason?) for Segregation . . Date of Segregation Protective Custody institution Security mdical El Inmate Request 0829/2014 advised of reason foreegregatIOn B??'r?ate advised of opportunity loMrilten submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives oppodunity for in erview with perintendenl ?Name ofSuperintendent/Designate (Print) Signatur ofsu intendent/Deslgna Date 4440 4 r? A 08/29/2014 Superintendent Decision (This secilon must be completed within 5 days of te's placement in segregation) inmate Submission . Superintendent Decision Release from Segregation 2/ Continue Segregation Reasons: 7. . Admitted to Seg iorr 5 0V3 .Neme oiSupennteZenUDesignale(Print) Signature ISup inlendenllDes' naie Date A a. /a 144, .- PW ?l?m 03/30/2014 - . . I VV Segregation Revrew (Inmate?s segregation to be reviewed every 5 days. into r'ew wlih inmate to be Conducted Very 30 days) - Inmate Submission - - - . I I S. Superintendent Decision Release from Segregation Continue Segregation Reas . . 5 . r\ Name ofSu erlntendenUDe'SIgnate(Punt) Sig tur fSuperintenden 'gnaie Dale I Ma?a. 62-} r7 I - . Supplementary Report for each Subsequent 30 Day Period ravage/of form for addi?oi? comments) Comments SuperintendenUDesignaie Signature Date . 521(1) ceo 075-100 '(10r04) 000119 Page 2 Regional Director Review . Continued Segregation Supported . Not Supported Comments r. (74.5 Name of Regional DireclortDeslgnale Signature of Regional Director/Designate I Data Kt Dew-L's - (mega. 2-7 or? HE Supplementary Report for each SubSequent 30 Day Period (use bottom of form for additional comments Comments Signature Date - Continued/Additional Comments ELSuperlntendent/Designate Comments Signature - . Date ma] 040; . lip/bl 9,9 M5 0?93 I I a? 9421/ 5105 . we?, Continued/Additional Comments by Regional VDireCtor/Designate Comments (45.5% V1.2 bug A ?int/L [xmm All, J: ?5st - 0' II I 24/.2319/ Signature Date . Mme) 521(1) 5.2 1 Odainal - Regional Director 10:11,: for Regional Director Review] I . - Copy- inmate File cso 075?100 (10104) I I . 000120 Ontario Ministry ?f (immunity Safety Segregation Decision/Review and Correc I Services i OttaweLCarieton Dentetion Centre Name (Last. First. Middle) Client Identi?cation No. Date of Segregation 29Jul14 Reason(s) for Segregation - ProtectIVe Custody El institution Security Medical inmate Request We advised of reason for segregation Era-yie?edvised of opportunity to make oral or written submissions I nmate waives opmunity for Interview with Superintendent nmate advised of opportunity for interview with Superintendent Name of SuperintendenUDeelgnate (Print) - - Signature oi Veno?n?bestgnate Date 29Ju 14 Francis Nolet. Deputy Superintendent Superintendent Decision (This section must be compteteo? within 5 days of the inmate's placement in segregation) Inmalo Submission - Release from Segregation - VJ luv Superintendent Decision - Ci Continue Seg?gatic?m Reasons: I Admitted to Seg for: A Name of SuperintendenUDesignale (Print) Signature Verihmoesignale Date 30Jui14 Francis Nolet. Deputy Superintendent - I Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted artery 30 days) - inmate Submission Superintendent Decision Release from Segmetion 3' Continue Segregation Reasons: DAY: Name of Superintendent/Designate (Print) Signature-o endenUDesignate Date View? :2 - as Supplementary Report for each Subsequent 30 Day. Period (use reverse ottom'ror additional comments) Comments - Superintendent/Designate Signature Date 7 I 5.21 (1 cso 075100 (10/04) 000121 Regional Continued Segregation Director Review Supported El Not Supported 7i . Page 2' oar 57/694? Name of Regional Director/Designate (Print) Signature of Regional Directorroesignale Date I ng' arr/,4 Supplementary Report for each Subsequent 30 Day Period (Use bottom of form for additional comments) 7? Comments Signature . Date Mde/vyw Continued/Additional Comments by Superintendent/Designate - - Comments? . Si lure Date . 4 34' new; rim-Q 4 1y th reg?CAN \urM -U~dr' I Hg 7" 50 4" \A'Vhst?- A Continued/Additional Comments by Regional Director/Designate Smnmum Dam - Mime (onwiwua, Dom/L. ~4me'7uv; t4] p6m?n521(1) Olsmbuuon: Original a Regional Director {Only for Regional weararRevrew) - Copy- Inmate File i 7 .CSD 075-100 000122 a? a pd . he Ontario Ministry of Community Safety Se re ation _eview and Correctional Services .9 . OttaWa-Carieton Dentetion Centre Client Identi?cation No. Name (Last. First, Middle) Reason(s) far Segregation I Date .of Segregation Protective Custocy Institution Security Medical Inmate Request 04/30/2014 i3 Inmate advised ol-reason for segregation animate advised of opportunity to make oral or Written submissions I Inmate advised of opponunliy for interview with Superintendent nmate waitfgsopportunily for Interview with Superintendent Name of Superintendent/Designate (Print) Signature of nta denUDeeignate Dale Francis Nolet. Deputy Superintendent 04/30/2014 I Superintendent Decision (This section must be completed within 5 days of the inmate?spiaoament in segregation) inmate Submission Superintendent Decision Release from Segregation Continue. Segregation Reasons: . - - Admitted to Seg for: - WW Name of Superintendentioesignata (Print) Signatur 3 per' tendentiDesignate Date Francis Nolet, Deputy Superintendent 05/010014 I Segregation Review (inmate?s segregation to be reviewed every 5'days. interview with inmate to be conducted every 30 days) inmate Submission Superintendent Decision Release from Continue Segregation . Reasons: - I 7' i DAY: 3 View Name of_ Superintendent/Designate (Print) Signature of SIWENimasignate Date - os- of?ut - Supplementary Report for each Subsequent 30 Day Period (use reverse orform for additional comments) Comments SuperintendentiDesignate Signature Date MMiddimy 5.1 5.411? cso 075?100 (1 0104) 000123 . 1 Regional Direckor Review Page 2 Conlinued SADPorted Not Supported Comments 0% crave/7 NJ: Name of Regional DirectorlDeslgnate (Print) Signature of Reglonal DiteclorIDeelgnale Dale ZZS Km) 5 early Supplementary Report for each Subsequent 30 Day Period {use bettom of form for additional comments) Comments Signalure Dale r_ ConlinuedlAdditional?Comments by Superintendent/Designate Comments . Signalure Dale \L?ko Wm r-U1 g? 7 1" - .m regwgk z' ContinUedIAdditional Comments by Regional Director/Deal nate Commanls Signalure Dale MMIddIym lug/[Me ru??Yrd-acf? '14 (M 24M407wv (Mm: my 4 oh - ufh77bv? iu?'mww h?oc WM raqv . f/ 7 9/ - original - Regime; Dlmdot {Only for Regional War Review) Copy - mmala Filo (:50 075.100 (10/04) 000124 ens-e A A ISegregatIon DecretoaneVIew Ef>0ntari0 - I gr on 0000 5 Name (Last, First. Middle) . i W?calion No. Reason(s) for Segregation - Date of Segregation Protective Custody Institution Security I Medical CI Inmate Request 03 Juiy 2014 I Inmate advised of reason Ior segregation inmate advised of opportunin to make oral-er written submissions Inmate advised of opportunity for Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name ofSuperintendenUDeeignaie (Print) olSuperinlenden signaie Dale 2am! mm ?44/ Superintendent Decision (This section must be completed tiriihin 5 days or the inmate'spiacemen gregaiian) Inmate Submission - . i . i Superintendent Decision Release from Segregation it? Continue Segregation Reasons: i SUIICIDIQL I Name ors denIIDeslgnat (F'rinIi)E reofSuperini esignate Date 0M1 tum/MA 07' 04"! A . I Segregation Review (Inmate's segregation Io be reviewed every 5 days. Ini?ervlew with inmate tome-ted artery 30 days) inmate Submission . Superintendent Decision Ci Release from Segregation [Ii/ Continue Segregation Reasons: . Meir?cqi Obserua?IiLt?a Name ie dent/De ?gnale I Signal of Superint Date ?v'r?n?mi iaumt 07'Qh??f? signate .- Supplementary Report for each Subsequent 30 Day Period (use verse offamn fair Comments . Date SINIIR - MMIdd/my 5.21 (1 5.21 (:50 075-100 (10/04) 000125 Page 2 1 Regional Director Review Continued . Supported Not Supported Comments /f7Ml/& MEL Cox/k . 0/ Amigo - I 7 Name of Regional DirectorlDesignate (Print) . Signature of Regional DirectorIDosignale Date SUpplementary Report for eaoh Subsequent 30 Day Period (use bottom of form for additional comments . Comments . - Signature 7 - Date Continued/Additional Comments by Superintendent/Designate Comments I Signature Date QC hum} wolf? re" ?m (Eg??wl \tvn? I mg?ng uvdt - Cid Ito? E45 wgCAQ?n.? tit/th {rm-{Er 4? April 8?5 ragkm 9, Marla: ?to macaw): Continued/Additional Comments by Regional Director/Designate .Commenls Slgnalura. Data ?aw/#75 44/9 4 5.7314145205411777" I 77254] $45414 b? 75318 35 Kroger/L772) I - - I - 52mDlatrlbulion: Original - Regiment Director {Only forRegionatDlrac-Jor?erdow) Copy - lmna?ln Fun cs0 075-100 (10104) 000126 A. Ministry of Community Safety I Segregation Decision/Review - - and Corr '255 - Ontario Asi/WeE I . inst' - V5 Ottawa?Carleton Dehtetion Centre Name (Last. First. Middle), _Ciienl Identi?cation No. - Reason(e) for Segregation Dale of Segregation Cl Protective Custody mutunon Security Medical Cl Inmate Request 09/012014 D-lnmale advised of reason for segregation male-advised ofopportunity lo matte oral or written aubmissiona Gimme advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendenilDeaignate (Print) Signature of SuperintendenUDesignato Date 09/01/2014 Superintendent Decision (This section must be completed Within 5 days of the inmate's placement in 'inmale Submission Superinlendeni Decision Release tram Segregalion - Continue Segregation Reasons: . Admitted to Seg for: Name of SuperintendenUDeeignate (Print) Signature of Superi ndentlDesignate Date - Pat Barnes, AIDeputy Superintendent 09/02/2014 . . . Segegatton Rewew {inmate's segregation to be reviewed every 5 days. Interview with Inmate to be conducted every 30 days) inmate Submission . Superintendent Decision Release from Segregation 13/ Continue Segregation Reasons: . DAY: . Cc: Nan?of upedntendenllDeaignale (Print) Signature of Superintendenuoesignate Dale M. i i (i b' (of Supplementary Report for each Subsequent 30 Day Period juse reverse arronm ror additionaiaomments} Comments SuperintendentlDealgnale Signature Dale . s.NlR a 91 PI . CSD 075-100 (19/04) 5 000127 i .1 R??lonal Director Review Page 2_ Suppo?ed Continued Segregation. - El Not SUpported Comments I Name of Reolonal DireclorlDesignale (Print) Signature of Regional DirectorIDesignate Dale . gee/W's 6 017? (74 Supplementary Report for each Subsequent 30 Day Period (u'se bottom of form for additional comments Comments Signature Date Continued/Additional Comments by Superintendent/Designate - Comments Signature Date . 7 (VDgear(WIFE Hana out (aura/Q ?own IO Continued/Additional Comments by Regional Director/Deggnate Comments . Signature Date i?j 5W (my/W Ar Min/L WW6. Win-Mn awe la ?wm/ WM Tumor/CSD 075-100 (10104) Disln'bullon: Original - Regional Dlreelnr (Only Inf Region at Director Review) Copy - Inmate File 000128 - . Miniatw?f9?mm?\i?it? Sm? Segregation Decision/Review Vontario and CorrecttonalServrces . Ottawa-Carleton Dentetion Centre it Lctiont Identi?cation No. Reason?) for-Segregation 7 Date ?of Segregation Protective Custody mum Security Medical Inmate Requast 08/26/2014 (V Qf?mate advised ofireaslon for segregalion aleadvised of opportunity to make oral or written submissions 9 Whats advised of opportunliy for interview with Superintendent ?ats waives opportunitifor Interview with Superintendent Name of SuperintendentlDesignate _(Prinl) Signature of Supe?nlandenUDeSignale Dale i jet Barnes, AlDeputy Superintendent . I . 08/26/2014 5? fix I Superintendent Decision (This section must be completed within 5 days ortno inmate?s placement In Segregation) inmate Submission . - . 7w I I Superintendent Decision Release from Segregation Continue Segregation Reasons: Admitted to Seg for: S'dih?k ?(S7mb760 Na'rrie of SuperintendentiDesignale $ng Date Pat B'arnes, lit/Deputy Superintendent - 0812712014 Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be concluded every. 30 days) inmatelslubmisslon - . 0/ Superintendent Decision Release from Seggagatlon 3/1 Continue Seqrega?on Reasons: - 7 DAY: Name of SuperintendentlDesignate (Print) . . Signature oiS par'm dent/Designate . . Date a Supplementary Report for each Subsequent 30 Day Period (use reverse ofronn ror comments) Comments SuperintendenUDeaignate Signature Date MMIiidIyy-yy {x 521(1) 9 r; . 3-, Cat) 075-100 .(10/04) 000129 an i 9. Page 2 Regional. Director Review Continued segregation. Ci Supported Nol Supported Comments I . .. Name ofReglona?l?DineclorIDesignale (Print) Signature of Regional DIreclorlDesignate Date W53 6007/}; Supplementary Repert for each Subsequent 30 DELPeriod (use bottom of form for additional comments} Comments 3 Signature - Dale - ContinuedlAdditional Comments by SuperintendenUDesignate . Commenls Signature Dale 7 - I A .. Vora' weuw? ny'lt/ \g . may?)? I {a 5 ?a q, [5,Continued/Additional Comments by, Regional Director/Desigat Comments Signature 0 Date {uh/V7: Mun/mow ego gs" Pm 0179c Dom ouoens'mws w: my Ac gmmaamu- can. ,7 A '1 5-WMMW . -- . - . . . I 050 075-100 (10104) Dislribulion: Original - Regional Dirtdor (Omy forRegIonsr Diractor Review) Copy? Inmale Filo 000130 u' or; a . JV g>0ntario Minietry of Community Safety and Correctional Services AXE (Se ation Decision/Review Institution Var Segregation - Protective Custody Institution Name (Last, First. Middle} CiieWn No. .Qttawa?Carleton Dentetion OSHA Security Medical Dinmate Request Date of Segregation 07/28/2014, 'mmat? advised of reason fer segregation - mittens advised of opportuntiy for, interview with Superintendent animate advised of opportunity to make oral ?or written submissions Ed/nrnate waives opportunity for interview with Superintendent Segregation Review (inmate's segregation to be reviewed every 5 days. interview inmate to be conducted evary 30 days) Name'of SuperintendentlDesignate (Print) Signature of Superintendent/Designate Date ran?is Nole?t. DeputLSu perintendent 07/28/2014 Superintendent Decision (This section must be completed within 5 days ofthe inmate?s placement in sagrega?og) inmate Submission Superintendent Decision CI Reiease from Segregation EV Continue Segregg?on Reasons: . - . . Admitted to Seg for: ad ,1 Name of SupennteneentIDesignate (Print) Signature ?E?enntendentinesignate Date Francis Nolet, Deputy Superintendent 0739/2014 I inmate Submission Releasie from Segregation Continue Segregation Superintendent Decision Reasonsour! @1651 Name of Superintendent/Designate (Print) Signature of SupennteneentiDesignate 4: Date Day Period (use reverse of form for additional Comments) I Supplementary Report for each Subsequent 3O Comments SuperintendenUDesignate Signature Date - cso 075-100 (10I04) {5 000131 Regional Director Review i I Page 2 Not Supmned Continued Segregation 3/ Supported Comments Name of Regional Diredor/Designate (Print) Signature of Regional Director/Designate Date Dan/3&2 4/ Supplementary. Report for each Subsequent 30. Day. Period (use bottom. of form foradditional comments Commen?s Signature Date MMidd/my Continued/Additional Comments by Superintendent/Designate Comments Signature Date - ?to gem/i ?tau?ELF u? may} {0 Own we,?wa [k Ci-{arjo/ 8S {Arm D013 ?nk? . 3'0 Chm?am was: ?b?Lrp/f Cen?nued/Additionai Comments b1 Regina! Director/Designate . - Comments Signature Date MMIddlm To imewLeLd? MP umber {bag/em Wang, ?05me ~r moi?5?4rzuu; . 5.21.(1) I Original - Regional Diracor (Only far Regions! Director Raw'ew) Copy File 1 . - 0513 07510000104) 000132 L5 Ontario Name (Last. First. Middle) Ministry of Community Safety =u Segregation Decision/Review mituuon Ottawa-Carleton Dentetion Centre Reese/1(8) for Segregation Protective Custody Institution security Medical mmaie advised of reason for segregation Inmate advised of opportuntiy for interview with Superintendent m?eques}. .. Eli/ nmat advised of opponunlty to make oral or written submissions Client Identi?cation?My I Date of Segregation 06/24/14 inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) we of Supe 'nt nl/Designate Date . I - . - irancis Nolet. Deputy Superintendent 06/24/2014 Superintendent Decision (T his section must be completed within 5 days of the Inmate's placement/in segregatmn) Iinmate Submission Superintendent Decision . Release from Segregation 12? Continue Segregation ReasonsAdmittedtoSegfor. Re-Ammy II VI he) I Unli? I I Name of Superintendent/Designate (Print) (IS/?naiu of Superi Designate Date 1 I I Francis Nolet, Deputy-Superintendent 3le ili Segregation (Vilma/E's Segregation to be reviewed every 5 days lL/erV/ew with Inmate tMnduc/sd every 30 days) Inmate Submission Superintendent Decision Release from Segregation Continue Segregation Reasons: I I . '1 DAY: 5 . saga? Wave. WWI. Name of Superintendent/Designate (Prinl) I Superi esignate I Date .. . Supplementary Report for each SubseqUent 30 Day Period (use reverse or form for ad comments) . - Superintendent/Designate Signature Date 5.21m . s)21(2)(f) CSD 075-100 (10/04) 000133 Page 2 Regional Director Review Entinued Segreggfion Supperted 7 El Not Supported Comments - - Name of Regional DIrectorIDesignate (Prinl) . Slgnalure of Regional DirectorlDesignate Dale K'vwve . __?yp_plementary Repon for each Subsequent 30 Day Periodluse bottom of form for additional comments Comments . Signature Date - . Continued/Additional Comments by Sugerintendent/Designete - . Comments gnome - Date MdeL? damn olwauA/f?' . 5% 3:55? 3 I ?15:945ng \w . 4? Ki - qoq? {if 50 - I I as. .rg?kg-L??w?m?ooe 7 q-Mw 5b" agreeing hub/~ng - 61/beij Continued/AdditionaI Comments by Regional DirectOrIDesignate Comments Slgnature Dale . ghafe wen, A) I geared 414/9 (jug [792 fa (gu??i/Dn . - - nau?x Original - Regional {Only for Regional Dire-o?er Rawaw) Copy - lnmale File . CSD 075-100 (10104) 000134 6 - ?mils?? O?Communlti? Safety Segregation Decision/Review 5 Ontario - and Corr' . :4 if: . - (Wulion - . . - Ottawa-Carleton Dentetion Centre? Name (Last. First, Middle) Ciient Identi?cation No. 'Reesonie) for Segregation Date of Segregation B/Protective Custody I lnsliiulion Security Medical ?nmate Request . 11?28?201 3 E?nmate advised of reason for segregation - I ?tnmate advised of opportunity to make are! or written submissions. "male advised 0' OPPOMRUY for interview with Superintendent mmete interview with Superintendent Name of SuperintendenUDesignete (Print) Signature of Ie nUDesignaie Date Francis Noiet, Deputy Superintendent g? Superintendent Decision (This sec-lion must be completed within 5' days of the inmate's placement in segregation) Inmate Submission - Superiniendeni Decision Release from Segregation Cenlinue Segregation Reasons: 0 . Admitted to SegtorName otSuperintendenl/Designaie (Print) Signature of_Su i den eslgnate Date Francis Noiet, Deputy Superintendent A I Segregation Review (Inmate's segregation to be reviewed every 5 days. interuiew with inmate to be conducted every 30 days) inmate Submission . . SuperintendenlDecieien El Reieesetrom Segregation [33/ Continue Segregation ROBEOHBZ i Anya/aide ('14 . Name of Superintendent/Designate (Print) Signature OFWHDesignate ta . ?martem 3:313 Supplementary Report for each Subsequent 30 Day Period (use reverse orrorm (or additionalcomments) . . Comments - Superintendent/Designate Signature Date . - s.21(1) cso 075-100 (10104) 7 000135 i a Page 2 Regional Director Review . c? - Continued Segregation supported Cl Not Supported Comments - Name of Regional DirectorlDeslgnate (Print) Signature of Regional Dlreotorlpesignate Date 6 Supplementary Report for each Subsequent 30 Day Period (use-bottom of form for additional comments Comments . - Signature Date' MMIdd/mry Continued/Additional Comments by SLIperintendent/Designate . Comments - . Signature . Date 2-9 1? "Joy?)0, 51w .9450 A . I . 4? 3:7 Su??{i Continued/Additional Comments QLRegional Directo A (All/?og r/Designate Comments . -- - Signature Date MM/dd/ygyy a \v - s.21(1) c. 21 pin) 050 075-100 (10104) . Distribution: Original ~?Rogional?0irector (Orin {arRegioneI Director Review) _Copy - inmate File 000136 . Segregation Decision/Review . Ontario . . I - - . 0 ococr Name (Last. First. Middle) i CWcalion No. Reason(s) for Segregation I - Dale of Segregation" CI Protective Custody Institution Security Medical ?ats Request . AUG 21 2014 Inmate advised of reason .for segregation Inmate advised of opportunity tom'ake oral or written?sitbmissions Inmate ?aduieod ,of opportunity tor'intenliew with Superintendent . I lnmalwaives for Interview with Superintendent . Name ofSuperlntendentlDeslgnate (Print) Signal uperln ndenUDeslgn le Date - GODW - {nggigil/Lde/j Superintendent DeciSIon (This section must be completed within 5 days oflhe Inmate's placement in segregation) inmate Submission Superintendent Decision Cl Release from Segregation . VD Continue Segregation ?t?sons: pgomg mum; our?: Morten. ?e?m'l MSBUUFED Tileme oi' SuperintendenUDesignate (Print) Signature I intendenUDesign-ate . Date I i - I Se l? atton Rewew {Inmate?s segregation to be reviewed every 5 days. lnlenn'ew with inmate to be conducted every 30 days} In Submission Superintendent Decision Cl Release frorn Segregation Continue Segregation gems: . Name oiSuperintendonUDesi nate (Print) . Signatore olSupe tendentloesignate . Date i - 24- ee Supplementary Report for each Subsequent 30' Day Period (use reverse oflanm for additional oomments) 7 - Comments SuperlnlendenUDesignale Signature Date . I . - . I 21(1) cso 075-100 (10/04) 000137 ea 35 an new, ROntario. segregation Decision/Review Institution SUppiementary Report for each Subsequent 30 Day Period (u OCDC Name (Last. First. Middle) Client Identi?cation No. Segregation A Date of Segregation Protective Custody institution Security Medical inmate Request 23 Aug 2014 inniale advised of reason for segregation inmate advised of opportunity to make oral or Written submissions Inmate advised of ogporluntiy for interview with Superintendent Inrnala waives opgonientty for interview with Superintendent Name of Su riniendenUDesignale (Prini) Signature of entID to Date 5' [(90:51 . 1, 23 Aug 2014 Superintendent Decision (This section must be completed within 5 days of the Inmate?s pia?menlm egregeiion) I Inmate Submission . . . . - I Superintendent Decision Release from Segregation Continue Segregation Reasons: one?! Valuer? I . ,1 Name of SuperintendenUDesignaie (Print) . Date Segregation Reviow'nnmare's segregation to be re viewed every 5 days. Inton?ew with Inmate (a be conducted every 30 days) inmate Submission . - . _Superiniendeni Decision Ci Release from Segregation Continue Segregaiion Reasons: I ?0 surfs Name ?oi SuperintendenllDesignate (Print) Signature of Super Fwdentioesignaio Date . MAW - - reverse of form for additional comments) Comments StipetinlendenllDasignaia Signature Date 01:1\ WE I I I 030 075-100 (10104) 000138 District Administmtor Review Page 2 Con?nqu Segregation Supported i No{ Supported Comments Copy - Inmale His (:30 075-100(10104) Nam? of Distn'ct AdministratorlDeslgnata (Print) Signature of Administrator/Designate Date 24 Wk Meme/Q Supplemental)! Regan for each "Su'bsequentao Day Period jyse bottom of form for additional comments) Comments Signature - Date . . . 4 ContinpedJAdditional Comments - ., Sunmum Dam .. thdw?yw C) C3 (Mn reaps?Jr A 3" 7,19/ I 0 L0 awn 15 6,17,-w/ 3o? Eggpu?vJ?C?k 973:?th ContinuedIAdditional Comments by Distn'ct Administrator/Designate Smnmum Dme - - .. MMId?d/ygyy {mt (HEM mar Am g?tggl 4 Quee'agfaa? a; z. (Ecume @1237; 1411' Lt?: LM Va? ?ecum . I Inn-.93 nun umf 113:: Remy; ?eh; wereqJJL-ltf I S. - - I 's.21(1) - ?irt alsm'by?on: On'aina! - mama Administrer {Only for EMdAdminis??mRa?eny 000139 )1 Ministry: of Community Safety Segregation Decision/Review i by} . I Ontario ?ea Won I Ottawa-Carleton Dentetion e. Name (Last. First Middle) N?El?ient Identi?cation No. I B?ate Request Protective Custody Institution Security DMedicai I Reason(s) for'Segregation Date of Segregation I 08/20/2014 211111318 advised of reason for segregation Dun-rate advised of opportur?y for interviewwith Superintendent. Inmate advised of Opportunity to make oral or writtensubmissions mmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print). Signature of Superintendent/Designate Date Pat Barnes, NDeputLSugerintendent "08/20/2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s plao?meni in segregation) lnmat?'Submission i . Superintendent Decision Release from Segregation D7 Continue Segregation Reasons: . . Admitted to Seg for. over?ow of C,Pod A . .Name of Superintendent/Designate (Print) Signature Wnate - 9 Date Pat Barnes. NDegy Superintendent 8/21/2014 . Seg regation Revrew (inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 day/3L inmate Submission 9/ A Superintendent Decision Continue Segregation Cl Release?Fer Segregation 3w? ?tandem/Designate (Print) Signature cisfr?hw Name I Date 25? o; Supplementary Report for each Subsequent 30 Day Period (use reverse Emmi far additional comments) Comments . . Superintendent/Designate Signature Date MMIdd/my . s.21(1) (380 075-100 (10/04) 000140 jazz-5:: R?giOnal Director Review Cominued SegregatiOn Comments SUpported' . (77/074 47%5? mhm? . Not Supported Page2 Name of Regional Director/Designate (Print) Signature of Regional DirectorlDesignate Date de?U/ Supplementary Report for each Subsequent .30 Day Period (use bottom of form for additional comments) Comments Signature - 0 Date - - MM/dd/ym Continued/Additional Comments by Supe?ntendenVDiagnate Comments Signature Date IO aka-emu - OJJW f?k 959? 7. than . qaLc/ Continued/Additional Comments by Regionai Director/OWE Comments 2 Signature Date MERE @100 we? ?12. {Zemew MTC Hes" My MSeS?ei) KR Cm: Pic-'1 winch 05? 051,; my! ?3 \c cf?eo?? - - 5714(2jiui) . . - CSD 075?100 (10/04) Distribution: Original - Regional Diredor (Only for Rowena! 01mm Renew) Copy - lnmmo File . 000141 Segregation Decision/Review In OttaWa-Carleton Dentetion Centre Neme (LaSl. First. Middle) Client Identi?cation No./ neasonts) tor segregation Date of Segregation 23Ju114 mmale advised of reason for segregation Mate advised of bpportuntiy for interview with Superintendent Protective Custody Institution Security Medical B?ate Request D?ihmale advised of opportunity to make oral or written submissions wane Wait/es opportunity for interview with Superintendent . were Name of SuperintendentlDosignate (Print) Signature of Sthe Date . Francis Nolet. Deputy Superintendent I - 7 23Jul14. Superintendent Decision (This sectionmust be completed within ?5 days of the tornate's placement In segregation) I Inmate Submission . Superintendent Decision Release from Segregation El Continue Segregation Reasons: Admitted to Seg .for: Vi Name of Superintendent/Designate (Print) Signature of uperlntendenUDesignaie Date Francis Notet, Deputy Superintendent . . :24J7uli4? Segregation Review {Inmate's segregation to be reviewed eVery 5 days. interview with inmate to be conducted every 30 days) inmatetSubmission Superintendent Decision - Release from Semation Continue Segregation Reasons: 5 OHM Name of Signature of So rtntendentjDesignato . Date :ib??i?ht? 7 at? I . I Supplementary Report for each Subsequent 30 Day Period (use reverse offom'l for additional comments} Comments SuperintendenUDeeignate Signature - Date! - . . . rind. 201V 030 075-100 (10/045 s.21(1) 000142 4 . Regional Director Review . Page 2 Dlamnutlon: Original Regionhi Director (any Regional Diract?orRiaWoM Copy lnmatq Fits 030 075-100 (10I04) Continued Segregation El/ .Suppo?t?ed 7 El Not Supported . Comments A . . I Name. of Regionol'DlrectorlDesignate (Print) . Slgnature of Regional DirectorfDestg'nate Date - - Su plementary Report each Subsequent 30 Day Period (use bottom of form for additional comments - ,Smnmum Dam - . ContinuedlAddittonal Comments by SUp?rintendenUDesignate Comments Signature . ?awaits Mr .3) t?Lonqoa/?Llotv . . . . . . 4? IN, '4 0?0 ?74' ib ,moom?odklatk 9? tww'wwc It,? (LII <3 all. Continued/Additional Comments by Regionai Director/Designate - Comments Signature Dale . i Mirac- imwm' Am '17. haw QCMQIJWM Fur [413 Sam Av? Quanta; death ()th . .NIR 7 49/ 5-14tdit0)? . s.21(1) 1 000143 . A Sire? I segregation Decision/Review) I a 9 Ice - ntano -- . - Ottawa-Carleton Dentetion Centre Name (Last. First. Middle) Ciientidenti?caiion Reaeoms) for Segregation - I I Date of Segregation ProtectEVe Custody m?tu?on Security Medical El Inmate Request 08/22/2014 gamete advlsed?of reason for segregation Emmate advised of opportunity to make oral or written submissions ?g?i?ate advised of Opportunity for interview with Superintendent mate waives opportunity for interview with Superintendent Name of SUperin?tendenl/Deeignate (Print) Signatu of,Superintendent/Designate Date Pat Barnes, A/Deputy Superintendent 08/22/2014 1/ Superintendent Decision (This section must be completed within 5 days aflhe Inmate's placement in segregation) Inmate Submission Superintendent Decision I Release from Segregation . - Continue Segregation Reasons: Admitted to Seg for: I (?43 Name of Signay?a?intandem/Designate Date Pat Barnes. A/Deputy Superintendent 08/23/2014 segregatlon (Inmate's segregation to be revisit/ed every 5 days- interview with inmate to be conducted every 30 days) Inmate Submission - Superintendent Decision Release from Segregation Continue Sgegregation 1 Reasons: . DAY: Name . Signature uperinlendenUDesignate Date- - - . Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date a - SINTR - - 521(1) cso 0757100 (10104) 000144 Page 2 . .\.Regional Director Review Continued Segregation Supported NotSupported - Comments ?7 9477A _N?ame of Regional DirectorlDesignate (Print) Signature of Regional Director/Designate Dale Supplementary Report for each Subsequent 30. Day Period (use bottom of form for additional comments - Comments Signature Date Continued/Additional Comments by Superintendent/Designete Comments - 3 Signature Date 4&9 mzamowAwl/i?e - . mqu "g I Geob?f?_ 2?5 2g tmw??utm 27L cam/m Ego 7 'i I arr?L4 Continued/Additional Comments by Regional Director/Designate . Comments Signature - I Date loom:- emu/mm em. a Der/m4 IM 0 inwwc/Note. A Ger/r 5% - Liwaiwmpa/AnVQV I I 9' ?3 ?l?fe. I I lair/4* ContinUedlAdditional Comments by Regional Director/Designate - Comments Signature Dale (NMTC. {gramme/agar ?ea/Hy 53cc 19f PU- man ?14! GUN Ewe: S.NIR f? s. i4(2)(d) . A I i .321?) I . .. A 53?] WV - DlaMbulIc-n: Original - Regional Dimaor (any rorneg'ena: amarnamw: . I Copy lnmale File . ceD 075-100 (10104) 000163 i Ministry of Community Safety and Correctional Services FAX Segregation Decision/Review inetii Ottawa-Carleton Dentetion entr lTame (Last. First. Middle) Client Identi?cation No. Reasonts) for Segregation mmate advised of reason for segregation E?mate advised of opportUniiy for interview with Superintendent @lecliva Custody lnstiiution Security El Medical E?l??iate Request El?n inmate waives opportunity for Interview with Superintendent advised of opportunity to make oral or writien submissions Date of Segregation 08/14/201 4 Name of SuperintendenUDesignate (Print) 311 ri Mani/Designate Date Franeis Nolet, Deputy Superintendent . 08/14/2014 I - Superintendent Decision (This section must be completed within 5 days of the inmate's placement In segregation) Inmate Submission Superintendent Decision EI- Release from Segregation El 7 Continue Segregation Reasons: I . Admitted to Seg for: 4? {11me 735 - A I - Name of SuperlntendentiDesignate (Print) Sig .. Date __E_r_ancis Noiet, Deputy Superintendent. 08/15/2014 - Segregation Review {Inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days} inmate Submisaion Superintendent Decision DAY: nerve-ea El Release from Segregation Continue Segregation I Reasons: I PM (tidLoo?x Name of SuperintendenUDeelgnate (Print) Signatu ?0%;Zirnende signate Date Supplementary Report for each Subsequent 30 DayPenod (use reverse offom'i Comments SupennlendenUDesignale Signature Date 's.21(1) CSD 0759100 (10/04) 000164 Page 2 i VJ Regional Director Review I . n? ;Conlinued Segregalion Supported . - NolSuppdned - Commenls . - WW A?/ucm; Name of Regional DirectorlDesignate (Print) Signature of Regional DlreclorlDesignale Dale . 6R - Supplementary Report for each Subsequent ?30 Day Period (use bottom of form for additional-comments I 4 - Commenls . Signature . Dale Continued/Additional Comments by Superintendent/Designate Comments nature Dale I i - l0. 'Ilhdovtfm?L?lt Nomi. 00 955.43: '20" - q'f'l?f 33/ l?wwds/?L?L?LQ . I 9" /2 Continued/Additional Comments by Regional Director/Designate Commenls SignalUre In Date - - A 1% Tc. Mrder ?umw jg?uiilkv?' '9 {grab ?19F%l) NIR ?fin 5. . . . Dlacrlbullon: Onglnal - Regional Direcmr (Only In! Regional DiredorRawow) Cepy - Inmele File 030 075-100 (10104)' 000165 nity Safety Segregation Decision/Review MinOntario - H0810 ?u Ottawa-Carleton Dentetm Name (Last. First. Middle) Client identi?cation Roasonis) for Segregation Date of Segregation Prolective Custody Institution Security El Medical mate Request 08/17/2014 Bynmaie advised of reason for segregaiton ?yinmate advised of opportunity to make oral or Written submissions Dri?male advised 0! Opportuntiy for interview with Superintendent Inmate waives opportunity for interview With Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date $iborcw - 7 Superintendent Decision (This section must be completed within 5 days or the inmate?s placement in seggaiion) inmate Submission - . . Superintendent Decision Release from Segregation Continue Segregation Reasons: - Admitted to 869 for: 0km] Name ofSuperintendenUDesignato (Print) Signature erintendentlDesignate Date Pat Barnes, AIDeputy Superintendent Segregation Review {inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission a _Superintendent Decision Release from Segregation Continue Segregation Reasons: 0m! ?macs-7 Meme Signet ofSuperintendent/Designate Date 8* as 9? Supplementary Report for each Subsequent 30 Day Period (use reverse ofr'orm Comments - I Date - - 5.21 i CSD 075-100 (10/04) 000166 egional Director Fieitiew Page 2 Continued Segregation Supported Comments Gull-wag Aer/wqu Why}; . Ci Not Supported Name of Regional DirectorlDeslgnale (Print) Dale Signature of Regional 'DireclorlDeslg'nate Supplementary Report for each'Subsequent 30 Day Period (rise bottom of form for additional comments) Comments Signature Dale Continued/Additionel Comments by Superintendent/Designate - Conunenm - - Sbnauue Dam r. . a - to Realm"! Eraser 1( Rude-J?) IV )2 bun lender? 5P (a 95' CUM ?i -I'i it! 3? 53-4?? 4451065? 01? hr Continued/Additional Comments by Regional Director/Designate . - Comments . Signature Date I mum: i?cwcweo 0N9 Baum; gececco'?ml I Lin Puumr. ~P/acmu7f More Red pr Trim owe till MM 651:. 9C WK 72% ,9 (ng:3, ?s.NlR s.21(1) - oso 075100 (10104) Dialnnumm: Original - Rngionel Direclor (anor?ihchgibnalDimdorRamw) Copy - Inmalo File 000167 - ?my Segregation Decision/Review .and Correctional Servrcas 5 - ano institution' .. ttawa-Carleton Dentetion Cent iteni Identi?cation No. Name (Last, First. Middle) neasomS) ror Segregation I - - I Dale of Segregalion Wrotective Custody Security Medical mm Reduest - 06/16/2014 mnmate advised oi reason for segregation . D?l'nmate advised of opportunity to make oral orwrilten submissions Mnale advised of Opportuntiy for interview with Superintendent Ei/nmalmivee portunity-for interview with Superintendent Name-at suparintendenuoestgnate (Print) Signal/4t: Date . Francis Nolet, Deputy Superintendent 08/16/2014 A 7 - . Superintendent Decision (This section must be completed within 5 days of the inmate'sptacemant in segregation) inmate Submis ion 4 Superintendent Decision El Release from Segregation Continue Segregation Reasons? Admitted to Seg'for: DUN Name Sign ?re of up I Wye A Data . Francis Noiet, Deputy Superintendent 08117/2014 Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted airer 30 days) inmate Sub ssion - Superinlendenl Decision Ci Release from Segregation l2, Continue Segregation RBBSOHS: DAY3 5 I Jpqun?rtm - . ., .1 Name of SuperintendenUDesignale (Print) Sign re 0 We: nate Date Baa/U- . 37 1% Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature bate . 521(1) (230 075-100 (10104) 000168- Regional Director Review Page 2 Conlinued Segregation Supported No! Supponed . . - . (hm/1 meat; ?rm/I Vl? A2 - ??mrmg Name of Regional Director/Designale (Print) Signature of Regional DlrectorlDesignale Date mix ?ow?A (/19 PM Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments), A Comments Signature Dale Continued/Additional Comments by Superintendeni/Designate . gnmu Dab . MNM??ngyr \mLo i0 ?2 Own (Rail/cc?? ContinuedlAddilionai Comments by Regional Director/Designate Smnmum. Dam s.21(1i . Disl?bu?nn: O?ginai {Regional Director (Onbr for Regional Director Ravigw) A 7- Copy - Inmate Filo cso? 075-100(10104) 000169 a- size Ministry of Community Safety and Correctional Services I Ontario FAKE - Segregation Decision/Review institution Ottawa-Carletbn Dentetion re Name (Last, First. Migdie) . Client identi?cation No. Reasonis) for Segregation Elinmalo advised of reason for segregation ?inmate advised of opportunity for interview with Superintendent Protective Custody institution Security El Medioai El inmate Request Dale of Segregation 08/14/2014 DJnmate advised of opportunity to make oral or written submissions inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignale (Print) Signature of Superi tandem/Designate Dale Francis Noiet, Deputy Superintendent 03/14/2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s piacemenr in segregation) inmate Submission . a Superintendent Decision Release from Segregeli'on 2' Continue Motion Reasons: . Admitted to Seg for: misconduct Name oiSuperintendent/Designate (Print) Signature of Su I r?W Date Francis Nolet. Deputy Superintendent I 03/15/2014 Seg regaiion Review (inmate?s to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) I Inmate Submission 0 I Superintendent Decision [3 Release from Segregation Reasons: DAY: 3/ Law Continue Segregation . Name of SuperintendenUDesignaie (Print) CFEerenrt? SignatWinEndentmeelgnale Date Piqwlif Comments Supplementary Report for each Subsequent 30 Day Period (use reverse ofi'omi for additional comments) Superintendent/Designate Signature Date . siuR snruzyd) 5.41m 075-100 (10/04) '000170 Regional Director ReView ?y Page 2 .SConlinued Segregaiion Supporied Comments CI Not Supported (if AW. 3.. Name of Regional DirectorlDaslgnaie (Print) Slgnalure of Reglonai Director/Designate Dale I 8% Supplementary Report for each Subsequent 30 Day Period (use bottom of form 'for additional comments Commenls Signature Date Continued/Additional Comments by Superintendent/Designate . Comments Signature Dale I . MMIddImryr JO WA uxL? 20 m\g. can); A "a 3 mgeoh?ue} . 377% go on?; mad/7 . 53% 9M Continued/Additional Comments by Regional Director/Designate Commenls Signalure Date - Adm/)1: traumati) Lufwti' ?aw? Cm leJL; (like C75 We?; (1 SW WMOKA fix/gout omw . 5.21 (1) . . Disjribullon; angina: - Regina! Dlraclor (om, Regional 01mm mil/sew; Copy - Inmate ?re CSD 075-100 (10/04) 000171? r? I . Ministry Of Community Safety Segregation Decision/Review - Ontario - and ices . - - -ro~1q 'or . I institution Wa?Carieton Dentetion Name (Last. First. Middle) Client 1W Reasonts) for Segregation Date of Segregation Protective Custody institution Security DMe/dicai inmate Request 07/15/2014 i3? mate advised of reason for segregation B'inmate advised of opportunity to mai'te oral or Written submissions Edman advised of opportunity for interview With Superintendent inmate waIVee opportunity for interview With Superintendent Name of SUperintendenUDeeignaie (Print) a 4 Signature of Supe den ignato Date Francis Nolet, Deputy Superintendent 07/15/2014 . . I . Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission . . - ?perintendent Decision Reiease from Segregation Continue Segregation Reasons: . Admitted to Seg for: WK i f? - 0 qith NM 4 PM, In: Name of Superintenden esignate (Pnnt) - 7 Signature of So i an esignaie . Date Francis Nolet, Deputy Superintendent - 07/16/9014 Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to tie oonducioo' every 30 days) Inmate Submission - . . Superintendent Decision Release from Segreoation 8? Continue Segregation Reasons: 0 Name ofSuperintendenUDeeignate Print) Signature perintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (Use reverse offomr comments) Comments I SuperintendenUDesignate Signature Date . s.075?100 (10r04) - 000172 . Rage 2 Regional Director Review Continued Segregation Supported - . Cl Not Supported Comments . . ?z?dwf/ . ?atm? Alf Name of Regional Direetorloesignate '(Print) Signature of Regional DirectorlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments - Signature Date - ContinuedlAdditional Comments by SuperintendenUDesignate Comments Signature I, - Dale -. . 3; a We ?Mi/i was LK {$05 . 31> MJ ?to; ?nkContinuedIAdditional Comments by Regional Director/Designate Comments I Signature Date - MAN: 4,10? ?uent ?rmwares? by m0 and! 61.4mm 1190-; 7-15?4?5/ A S. I I s.NlR I A. s.21(1) Distribution: Original - Regional Director {Only (orRegionaerdorRsviaw) Copy Inmate File 030 075?100 (10104) 000173 I . - - Ministry ofCommunlty Safety Segregation Decision/Review .r Ontario and Correctional Services 5123404 ~01 mam . FAXE tawa-Carleton Dentetton Cent Name (Last. First; Middle) - I Client ldenli?calion No. Reasonts) for Segregation - Date of Segregation El Protective Custody. Institution Security Medical inmate Request 08/13/2014 'mmate advised of reason [or segregation mnete advised of opportunity to make oral or written submissions - Wrote-advised otopportunliy for interview with Superintendent Inmate mines opportunity for Interview with Superintendent Name of SUperlntendentlDeelgnale (Print) Signalur perintendenttoesignale Date Francis Nolet, Deputy Superintendent 0811 3/2014 . I I . Superintendent Decision (T his section must be completed within 5 days of the inmate's placement In segregation) Inmate Submission - Superintendent Decision Release trom'Segregation ContinUe Segregation Reasons: . - Admitted to Seg for: gnu 1 7; Name oi Superintendenuoesignate (Print) Signature fSuperlntendent/Deelgnate Date Francis Noiei Deputy Superintendent . 08/14/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted eVery 30 days) Inmate Submission . . a ., Superintendent Decision Release from Segregation Continue Segregation Reasons: DAY: Name ofSuperintendenUDesignate (Print) - . Sigmly?s?Wignale Date I ban?m/ - . . Supplementary Report for each Subsequent 30 Day Period (rise reverse otrorm for additional comments) 7 Comments SuperintendentlDesignate Signature Dale n4:4\ ?cso 075400 (10104) 000174 a Regional Director Review Page 2 Continued Segregation Not Supported Supported Comments - /Ma?4&?4 4-17 Signature of Regional Director/Designate Date - Distribution: ought-Regional Director Copy-toms! CSD 075-100 (10/04) {Only (or Regionaioiractoc?ow?ow) 0 F119 Name of Regional DirectorIDoSignate (Print) L/lem r?as /2 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments - I Signature Date Continued/Additional Comments by.SuperintendentJDesignate Comments SignaIUre . Data . I I /7 A to Madam?? Fofh-ype? ?93 5 . ?Qxf? {DQ-t?a 3? It] 9-13. \WLomg'qu?o?i {mar 9~ 98? 7" w?le/ARW Qef 4437? I Continued/Additional Comments by Regional Director/Dealgnate Comments Signature Date -. (out?t mm to ?ew _1 Hut/t MM Wk? mo or ?ee- ApqubA'tUQW A I - - 33 23:1. I ,i 91(1) 7 000175 Segregation Decision/Review \MS?tb-ikh 0i Instilu Ottawa-Carleton Denteiion Cent e- Name (Last, First, Middle) - . \1 Client identi?cation No. ?'Reasonie) for Segregation A Date of Segregation? Proteciive Custody Ci Institution Security Ci Medical %eie Request 05/13/2014 Blnmata advised of reason for segregation El Inmate advised of opportunity to make oral or written submissions nmate advised of opportunity for Interview with Superintendent inmate waivec?ponuniiy tor Interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of pariWate Date Francis Nolet, Deputy Superintendent - 05/13/2014 Superintendent Decision This section must be completed within 5 days of the inmate?s "placement in segregation) inmate Submission SuperlnlendentDecleion Release from Segregation - Continue Segregation Reasons: . . Admitted to Sag 'for: misconduct Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date 1 Francis Noiet, Deputy Superintendent 05/14/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be Conducth every 30 days) Inmate Submission Superintendent Decision Release from Megalion Continue Segregation Reasons: - DAY: 5 0am Garzf?' Name Signaturaofy?ntend Designate. .. 'Date . 5- ?in. IE I Supplementary Report for each SubseqUent 30?Day Period (use reverse arrorm for additionat comments) Comments SuperintendentJDeeignale Signature Date 521(1) . 080 075-100 (10104) 000176 Page 2 Regional Director Review Continuad Segregation Supported Not Supported Comments . I mm .41. Name of Regionat Directortoasignate (Print) Signalura oi Reglonal Date ~r32/W3 {2m 7 w; 4; Supplementary Report for each Subsequent'30 Day Period (Use bottom of form for additional comments) Commenls Signature Date Continued/Additional Comments by Superintendent/Designate - Comments . Signature Date . . I /7 . A 45 ow timer?! 2/ - gown?! 00m pernqu - Vat-r - 3 f?Wh ??273 1U) my Q6 (ix/mm max)me? - I /7 a ?15k mu 'Mu??b 9-2047 0 . Continued/Additional Comments by Regional Director/Designate Cemmenta Signature . Date 7 me?bt A as Gluet'il 7: fling)?: 150 {Lumen/raw which M143 my mum: on - 21 NC 00o gb?z' *?sr t-ht - . i I Jada/x . . 521(1) 1 . OriglnuI-Reglomal Diredor I - I Copy Inmate File CSD 075-1 00 (10I04) 000177 .- - - . . [Wrg . tr" Ministry 3? cm Segregation Decision/Revrew Ontano and Correctional Servicee A - [q \Ottawa-Carleton Dentetion Qentr Name (Last. First. Middle) re 7 ?l ytws) for Segregation . I Dale of Segregation Protective Custody Institution Security Medical El Inmate geguest 12-14-2013 [210mm advised of reason for segregation . Binmate advised of opportunity to make oral or written submissions inmale advised ofopportunliy for interview with Superintendent inmate waives opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Signature of 'UDealgnate Dale Francis Noiet, Deputy Superintendent Superintendent Decision (This section-must be completed within 5 days of the inmate?s piecemeal in segregation) inmate Submission, - Superintendent Decision El - Release from Segregation (Er ?Continue Segregation Reasons: - Admitted to Seg for: Suicide watch - I Name ofSuperintendent/Designate (Print) - Signature of Superint UDesignate Dete . Francis Nolet, Deputy Superintendent . i ?4 L. a Segregation Review {Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted eVery 30 days) inmate Submission . - Superintendent Decision Release from Segregation . - tiZ?J Continue Segregation . . - mg -. atom Maid/i: . Siam (ac) buck Am Zia), LN - Signature oiS?peri De nale Dale ?i?Cril?ti/LA/ixiOCDk. a . ri??irS I. I Supplementary Report for each Subsequent 30 Day Period (Use reverse afform for additional comments) Comments Superintendent/Designate Signature 1 Dale - s.21(1) CSD 075-100 (101'04) . 000178 Regional Director Review Suppo?ed Continued 'Segregalion Comments No! Supported (92m Yams of Regional DirectorlDesignal? (Print) Slwre of Regional DheclorlDeslgnate Dale {Xe/.415 0? Maj Supplementag/ Reporl?for e?ach SubseqUent 30 Day Period (use bottom of form for additional comments) - Comments Signature Date 0 Day I Month I Year Continued/Additional Comment?y Superintendent/Designate Commenls Slgnalure Date 5V7 ML Day I Month I Yoar W?-w - as:qu w. in} I 9% \\Lfi\ uJ W. ow \u/m mgr? ?og I A 3WD mks/Xv?) A (O . - ContinUed/Additional Comments by Regional Director/Designate Comments Signature Dale Day?! Monlh [Year ?ower-7f 73 - lav wm77L?N 9/5/szsz Amt cit/jot ?Zrl, UV . - A s;14(znd) I - 3.21m - - Dla Irlbullon: Orlghid - Raglonol Director {any In! Re Copy - Inmalu File 080 075-100 (rev. 031201 1) glow! Q'rador Review) 000179 [Egg . . ., . gm. 1 Ministry of Community Safety .r rt . . . - and Correctional Servrees Ontario Segregation Decision/Review (?igwa-Carieton Dentetion Centre, Name/(Last. First. Middle) ciientW eon(s) for Segregation Inmate Request Date of Segregation 06? 0?201 3 ProtectiVe Custody Einstitulion Security Medical g?mate advised of reason for segregation Inmate advised of opportunliy for interview with Superintendent g/?uwrate advised of opportunity to make-oral or written submissions Inmate waives opportunity for interview with Superintendent Reasons: Admitted to Seg for: security concerns Name of SuperintendenUDeeignale (Print) Signature of 'nien Efesignate . - Date Francis Noiet. Deputy Superintendent . . - 0640-2013 Superintendent Decision (This section must be completed wimin 5 days of the Inmate's placement in segregation) I inmate Submission - . ?321(1) Superintendent Decision Release from Segregation Continue Segregation c. 21(2)(f) Inmate Submission Superintendent Decision Release from Segregation Continue Segregation Signature of ri tendenUDosignate Date Francis Noiet, Deputy SUperintendenl - l3 . I Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Reasons: DAY: .r ewe Name at Superintendent/Designate (Print) 3mm Dale i 3 Supplementary Report for each Subsequent 30 Day Period (use reverse ortomn for additional comments) Comments SuperintendenUDoeignate Signature Date 080 075-100 (10/04) 000180 Regime! Direcicir Review Page 2 Continued Segregation Comments Supported El Not Supported Name of Regional DIreclorIDesignale (Prim) Signature of Regional DirectorlDesignale 14% ?i Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments sew Dale Comments Signature Continued/Additional Comments by Superintendent/Designate - Comments . Signature Dale I a . ?95, "4 i kc,ka \kxik~\ Bx/q? ?43; ?[6744 (k - 3 \kvlm W1 A - LN) g- Hgga\ it}! Continued/Addluonai Comments by Regional Director/Dealgnate . Comments? Signature Date . (Ni/016, imwtcueo AM may (AA/now ,w (mac/{row <1:ka A4400 2m 7090 I 0 A 0 A o?i?IoTa/t/y Distnbulion: Original Regional Dimer (Only for Regional Director Review) Copy Inmate His (:50 070100 (10/04) 000181 "in?ate: Segregation Decision/Reuiew i . I DC DC 1 Name (Last. First. Middle) - Clien on No. 5? Reason(s) tar Segregation i Date or Segregation Protectivo Custody Institution Security gMedloai Inmate Request I 03 2014 Inmate 'advised of reason for segregation inmate advised of opportunity to make oral or Written submissions Inmate a?vised of opportuntiy tor interview with Superintendent Inmate waIVes opportunity tor interview with Superintendent Nameof Superintendent/Designate (Print) . oj'SUperinlenden slgnete . Date Ericka/O] I [1fo - July 2014 I I Stiperintendent Decision (This?sectton must be completed within 5 days of the inmate's piacemengacggregalion) Inmate Submission 7 . - i Superintendent Decision Ci Release from Segregation Continue Segregation 1 Reasons: i .i Date . Name 0t$ denUDesignat (Print I (blow/?1? . - Segregation Revrew (Inmate '3 segregation to be reviewed every 5 days. in rview with inmate to acted every 30 days) Inmate Submission i . . Superintendent Decision Release from Segregation Continue Segregation H.0bsler weird. n- Reasons: Name 'te denUngnaie ?at uperilnt Date ?gures: o7ror~rtt I signals . i Supplementary Report for each Subsequent 30 Day Period.(use ieverse orronn fdranments) Comments SuperintendenUDesignate Signature Date . . - - MIdelmy - I 91(1) CSD 075-100 (10104) 000182 District Administrator Review Continued Segregation Comments Supported ?at/r? Not Sugported [Sage i "Name of Districi Administrator/Designate (Print) Supplementary Report for each Subsequent30 Day Period {use bottom of form for additional co Signature of District Administrator/Designate mmentsommen QUE ure Continued/Additional Comments? Superintendent/Designate - Comments - Signature Date . I A - I I MM/dd/m?yr NJ abS-v K?Oj?lif (It) I A4 fly/V. ?at/Ly v/ll?/53/ v?C?k??q I ?37" . I . b0 mug? 4-01? p, . ,ContinUededditional Comments-by. District Administrator/D6559 nate Comments - SignatUre Date I Art/v17 lit/75AM 60w?? (C {it its. few For! 64 it: Atty/a mm [If/r?mw77 a. #147764,- - 00760 21 4:24 (Jolt i 21(1) 067 LT Copy - Inmate 0513 075-100 (10104) Diemtiullom Origtmai - Distruhaminlelralor (Only for'DJsma'.? Admit?strata'Ravian File 000183 - Ministry 0* ??mmunity Safety Segregation Decision/Review and Correctional Services' 1 ilOQ: to A Instituti - arleton Dentetion Can i Name (Last. First, Middle) i I Iient Identi?cation No. HBESOME) ror Segregation - Date of Segregation Ci Ecotective Custody Institution Sectirily- Egg] mmale Request 07/31/2014 In ate advised of reason for eegregation .iZ?lnmate advised of opportunity to make crater Written submissions Bog-time advised of opponumly for Interview with Superintendent mimate waives opportunity for Interview with Superintendent Name of SuperlntendenttDeeignate (Print) Signature of Su dent/Desi nate Date 1 Francis Noiet.? Deputy Superintendent 07/31/2514 Superintendent Decision (This section must be completed within 5 days of the inmate's placement In segregation) i Inmate Submission 5 i i i Superintendent Decision Ci Release from Segregation 1 Continue Segregation Reason51' - I Admitted to. Seg for: Mt t3 Whit. - - . Name of SuperintendenUDesignate (Print) A Signaturemsignate Date Francis Nolet. Deputy Superintendent 08/01/2014 Segregation Review {Inmate?s Segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision El Release from Segregation A Continue Segregation Reasonsy 6 0129;. Name of Superintendentgemt) I Signature of Supe went/Designate DateSupplementary Report for each Subsequent 30 Day Period (use reverse or form for additional comments) . Comments Superintendent/Designate Signature Date 521?) CSD 075-100 (10/04) 000184, A I I i- .4 0 Page 21 Regional Director Review . i . COntlnued Segregation Supported Nol Supported Comments - - H. Maj/2?Name of Reglonal DlreClor/Deslgnale Signature of Regional Direclor/Dersignale Dale a Report for each Subsequent 30 Day Period (use bottom of form for additmnal comments Comments Signature Dale M. Continued/Additional Comments by Superintendent/Designate 7 Comments Signature . Dale ?0 i960 or? Ps?lo'W?E? . @zrv/ 9,0 mm)? clogContinued/Additional Comments by Regional Director/Designate . Commenls \Slgnalure A . Date . -- - (Ml-41176 (Mavrcu?b lip/D . Whmw/ G?auag?lzw- ?rW Wm ?whw? - 'So . . r: 1419mm . IWM s.21(1) Dlelnhullnn: Onglnal - Raglonal Direch (Only for Regional Diraclor ?le view) Copy - Inmala File CSD 075400110104) 4 . 000185 1 i . Er. Ontario Ministry of Community Safety and Correctional Services 35?? Segregation Diec'if?eioaneuiew if)? - . . Hex-qu 5 Central East CoriectionaiCen? Name (LastI First. Middle) Reaagnisfior Segregation . C-E?rotectiva Custody. institution Security . El Medical Inmate Request No. Dale of Segregation 09 Ju114 inmate advised oi'reason for segregation inmate advised of opportunity ior interview with Superintendent inmate advised of opportunity to make oral or written submissions inmate waiue? opportunity ior interview with-Superintendent am?a of?SuperiniendenUDesignaiB (Print) Signature of Supri Designate Date Sgt. K. Stoiiere 11 July 14 Superintendent Decision (T his section must be completed within 5 days of the inmate's placement In segregation} inmate Submission . Admitted to segregation from 2F - i Superintendent Decision Ci Release from Segregation Continue Segregation RaaeoneDate Name at SuperintendenUDeeignaie (Print) E) Siggiure oiSu erinie enUDesignaie inmate Submission o; Superintendent Decision Er. Reiease irom Segregation .J boa/hail not Ara/$62502? mco cmo'a?ccfSegregation Rewew (Inmate's segregation to be reviewed every' 5 days. intarvrew min inmate to be conducted every 30 days) ..Contirrue Segregation; MM/ti 7L0 p0,) . Name of Superintendent/Designate (Print) ?Sn/i CCOiimuxiit-g/ - . Sig??aiure'oi SuperintendenvDasignate Date ?ppiemeniaijt Report for each Subsequent 30 Day Period (use reverse orronn foradditionaiicammenis) trdw?ita? 1 Comments SuperintendenUDeeignala Signature . Dale - I--. can 075-100 (10104) - I -s.21(1) .s-21tzitf) 000-186 50 ?Regianal Direcl?r Review -I Page2. Continued S?gleq?lion Gm Comrnenua Bad! I DI . 33 3U New: 05 Eggl?il Direclorloellgnalo (Pant) Supponed ?No! summed ?4 Ftp-(l Signalum Dale 0 . o?lt?E/Lam . I I supplem?ntary Report for each Subsequeni?ao Day Period (use bottom of form {or additional comments A Commenls Unto Signalma; . 58113;; Commanln Commenw by SuperintendenUDesignale Signawm Dale I 4v WOOL: 014.5%. . - .124. :4 a . I .40) rd W. I I - WSE Dj/zg/H?L ?IMoucmiof/jij_ 7 "41.04 [at It 5'79? 071$}qu- vb . I thmo I ad .3 I ogg/?fgfl?l - - I \Zc I DIE/Dallq? vodkaMaw Commahls wwional DlreclorlDaslgnale I - Comma?nm Signaluref - I CSD 070?100 (10/04) Dkl?bkllon: 0159M - Min-5 Mattel" (Only M??glmd mudd?ovim} Flu . s.21(1) 000187 .40 9 Regional Director Review "Continued-Semegalion Comr'nents . Ij Supponed Page. 2 DJ Not Supported Name . Dale i 1 Supplementary Report t0r each Subsequent 30 Day Period {use bottom of form fair. additional comments) I - Comments I lure Dale . . . . .- . . Md mew?? i0 mcUcL, me .- 3' \t on Acpbmi ss (g4 121.1?1? (ngy: Md 1-1ng Continued/Additional Commenls by Superintendent/Designate Comments Slgnalure 7 Dale03] tam,? (Re?L?xul?fm 45. f1 cg @Mo?b?wm Ans." elm/144 A411ij on +19 MM Pin/1+ ?gala?9 bl} (L I yak": twig?f Di cut/M ?ml/M - _ContinuedIAddilional Comments by Regional DirectortDesignal 21am Comments 6 3! nature? - Data I 5.21?) . (:50 075-100 (10104) Distrihullnn: Onglnal - Raglanal Dlroclor {Only for Regional Dt'fectof??vt?w) Copy - File 000188 Page 2 - Regional Director Review 'C?niinued Segregalion El Supporlecl I 2 Mel Supporled Commanls? - Name of Regional DireCan?Deslgnale Slgnalure of R?glnnallDiraclon'Deaignala Dale Supplementary Report for each Subsequent 30 Day Period (use boiled) of form [o'r additional comments) Comments . Sldnalura Dale f1[in? te MWW 'Wm'm /0 - .0 . Kayla/Mo h) . 7 ?z Continued/Additional Cominenls by Superintendent/Designate i CummanIS- Slgnalure' - Dalu . A um.? L?mm-?M Amemwm-J? \1 . 40% M.M . (LQWS I . axe 834% Ci/QQ/?ll bed . - i . .Aub pug-WWO +137 cf, ?71 9?{'74 .m ffmb?f?? m3 ?Md /0 . l2. {2MWW (0.17.195 Conlinued/Addilional Comments by Regional Director/Designate Commenls 7 . Slfnalu're' M21319 Iyy? Ole Illbullun: 009ml - Raglqu Dlreclnr (Only for Regional Direclor Roi-id w) Copy - Impala File 075-100 (10104) s.21(1) - 000189 106 HO Regional Director Review Page 2 ?0 a Lonlinued Segregation Supported . - Not Supponed Commenls ?90 A Name of Regional DirectorlDeslgnale (Print) Signature of Regional Dimmer/Designate Dale ?oearf?wa Supplemenlary Report tor each Subsequent 30 Day Period (use bottom of form for/ additional comments) -- . Commenls . gnalure Dale . - MM #2618? 7, ConllnuedlAddilional'Comments by Superintendent/Designate Commenls Slgnamre Dale I .7 ImmacLo. /0,22(LP ?3;qu \13 mm? 'm gun-?ex . M4 I. Emmi/$111. f?pmgg .43..) deg-g . . #0 k? Ill-071$ . .eo: ?aminuedlAdditional Comments by Regional Dlreclor/DeSignale "H-x Commenla Sinalure Dale on alrlbul ion: Original - Reglunal Diteclor (Only fur?eglonal 0mm Review) Copy - lnmalc F?u - S. cso 5 21(1) - 000190 Central East Correctional Centre Inmate Sabmialon for 30, Day Segregauon R?Vlewa Ilnmate Name; OTIS Number: Inmate submission for 30 day segregatlon review: Inmate Or?! Submission for 30 day segregation review: (To be completed by Se regatlon Manag?er) 04%3 rio?t Ch) {60 ?17) (El . fod?xmaq emcL n9 pLL/Coqu Inmate signature: Date: November 12. 2014 WlthessName: -S.McWh nnlel A . 'WItneSs Slgn?ture: s.21(1) - 000191 '1 1 Ministry of 0ommunlty Safety iv and (Ewg?g?r?ces I: - :3 it"? {0?07 Segregation Decision/Review ,lnetltu'tton it Centrat East goriectional Name (Last, First, Middle) Reason(s) tor Segregation Inmate advisedof reason tor segregation inmate advised ot'opportuntty for interview with Superintendent Protective Custody Institution Security El Medical Inmate Request Inm'ate advised ot opportunity to make oral or written submissions Client identi?cation No. i Data at Segregation 09 Jul 14 inmate waives opportunin ior interview with Superintendent Name of SuperintendenttDesignale (Print) Signature of Super' signate Date Sgt. K.'Stofters I 11 July 14 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate submission I - Admitted to segregation from - Administrative segregation requires protection - - 7 i Superintendent Decision Release from Segregation Continue ?gregation Reasons: . I Ms 6m an 94?]th Name of Superintendent/Designate (Print) Date ndeltUDeslgnate Signature 0% ii Inmate Submisslon . - i Segregation Revrew (Inmate's segregation to be net/towed every 5 days. Interview with inmate to be conducted every 30 days) \j ?gm-7442420 7mth Aer/J, sj Superintendent Decision Release trom Segregation [3 Continue Segregation Reasons: 4 .. tee Womemw 74:07ng mms?je?nt Name of SuperintendenUDesignale (Print) Signature of SuperintendenUDesignale Date 14. Suppiementary Report for each Subsequent 30 Day Period (use reverse of form Ioreddittonetoomments) Comments Superintendent/Designate Signature Date a I . 050 075-100 (mm) s.21(1) 000192 Regional Director Review Page 2 Continued Segregation Supported . Comments Cl Not Supported i Name of Regional DirectorIDesignale (Print) a . Signature of Regional DlreolorlDeslgnato Date Supplementary Report for each'Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature: i 1 Dale MM- Continued/Additional Comments by Superintendent/Designate Comments Slgnalure: Dale 35.20460 :?Jme?fc,? it aria. 4/27/14 MydP/omjdm W3 bin??44; ?bre-i Amp/Fem WW lax-W?s to WM w? J?o?s 5 Wm?. 6 ?57? NJ. cowMContinued/Additional Comments by Regional Director/Designate Comments Slgnature Date i i Olalnbullon! Original - Regional Olreclol (Only- Regional Dim-do? Raulan Copy - Inmate Filo 030 075-100 (10104) i i s.21(1) 000193 is {1 (pi am 4 cud; Regional Director RevieiL Page 2 Continued Segregation Cl Supported Nol Supported Commenis EName of Regional DlieciorlDeslgnale (Print) Slgnaluro of R?gionai Direclo?Designale Daie Suppiementary Regort for each Subsequent 30 Day Period (use bottom of form fo'fq?monai commenls) Commenla I - Dale 1? I 1 .ll' rouic-Lccl ??f'?tnmi'f mam QWiu/m :1 'pp . Oral vaegu'ssl mm I I 01/81/14 a .. wl?m I '11) 4'12) peep (e ?i??nni ConlinUed/Additionai Commenls by SUperinlendeni/Designaie i Commenls 7 Signature Dale 1 . $2.;th Ogilgl?" . . I $79, ?1 ?Yukon fawn-0H6 Mama?ED . h? um? .AIL- . {Edi-Won P??lcmau 5L Mn (Mia/All i ConlinuedlAddilionarl Comments by Regional Director/Designat (D Commonls . Signature' I Date - Bldrihullon?. 0119an Regional Direcinr (Only for Regional Director Review) Copy - Inmala File 050 075-100 (mm) s.21(1) 000194 District Administrator Review El Continued Segregation Cor'nrnenls Suggoned El Not Supported Page-3'2 Name of District AdministratortDaslgnaie (Print) Signature of District AdministratorIDesignate Daia Report fer each Subsegurent 30 Day Period ?rse bottom Of form for additional comments Comments Signature Date (?10 A hn'xait? atria ML rad] l0 I _ContinuedIAdditionai Comments by Singerintendent/Designate - - - Commonls Signature . Dale . . A. L?c? {iv/k 89-2: 03 we; 9 hat/?F W3 7?9 yer/L @502, I Wamkvm" - ?85 ?m . 3+0 /oa0a-/l/ Q0 Vuth ?i-U MW Pix-L: cm (0.0?7 thLM. 4a 6* i loo We jollj'vl?f nate. - Comments Signature Dale I MMIdd/yygy . s.NlR 521(1) 941')\ tn ?nk urrvT 080 075?100(10104) Distribution: Original - Disuid Administrator (Only for District Administrator Ram'etv Copy - Irmatu Filo . 000195 .. (Central East Carrectionei Centre inmate Submission for 30 Day Segregation- Reviews Inmate Name: OTIS INUmber: Inmate written submission for-30 day segregation review: Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) inmate signature: - Date: Octoi?r 7. 2014 Witness Name: 8. Witness Signature: s.i\llR 521(1) 000196 ?CentraI East Correctlonal Centre Inmate for 30 Day Seregatlon Revlews Inmate Name:_ OTIS Number: Inmate ertten?submission for 30 day segregation review: I Inmate Oral 30?day eegregatlon revIeW: (To be completed by Segregation Manager) 521(1) Inmate signature: Witness Name: Witness Signature; 8 S. I Date: "_Noyember 12. 2014 000197 HO Regional Director Review Page 2 Continued Segregation Suggorted Not Supported Comments.- I Lamart? ??36 Liti'He-v? Signature of Regional Director/Designate Name 0! Regional DjtectorlDesignale (Print) Date ?2/07/Za?? Suggementaly Report for each Subsequent 30 Day Period (use bottom of foFm for additional comments - . Comments Date JJW/S?tatore Maw/2W . Continued/Additional Comments by StgerintendenUDesignate Signature -- . Mw?stgw ET m1 /0 - 1% wqu"w~ ?Im ?gum Jugs as bigot 1'0 3ro (Mull/t . - Continued/Additlonal Comments by Regional Director/Designate . Comments Signature Date NIR s.21(1) 050 075-100 (10104) Odgtnat - Regional Diracch (Only form-glans! ?redorneviaw) Copy - Inmate File 000198 an 1 We? Segregation ecisioaneview . 7' a rrec one I 9 see . 1" Ontario . . . ??ngg; *3 Jgsmuu'a?? n- 7 - Permit) - ,i Central East Correctional Centre Name (Last. First. Middle) I - (:15 Client identi?cation my Reasonts) for Segregation I - I Date of Segregation Prolecthre Custody institution Security Medical Inmate Request 10/13/2014 Inmate advised of reason [or segregation inmate advised of opportunity to make oral or written submissions inmate advised of obportuntil for interview with Superintendent . Inmete waives opportunity for interview with Superintendent Name 0' SUDenntendenUDeeignate (Print) Signature of Superi )endenUDesignete Dale Mn-Ne'rl-Neville- g-MUDttwulrg', . We 9' 10/13/2014 i Superintendent Decision (T his section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission 2 Subject states he has dif?culty dealing with other inmates claims he will hurt someone if piece on a regular unit ?perintendent Decision Release from Segregation . i . PEI Continue Segregation Reasons: To remain as per his own request - referred to Name of Su??ntendentmesignate (Print) 7' Signaturenot Superintendent/Designate Date S. McWhinnie 10/15/2014 Segregation Review (inmate's segregation to be reviewed Wei}! 5 days. Intervieit/ with inmate to be conducted everyJO days) inmate Submission - I Superintendent Decision Release from Segregation Continue Segregation ?7 gsons: NS 413 . 'l LNome ol SuperintendentlDeeignate (Print) Signature of Superin denUDesigneto Date Smowemme MW 20.14 Supgementary Report for each Subsgc?lent 30 Day-Period (use reversgofronn for additional comments) Comments SuperintendentlDesignate Signature Date cso 075?100 (10/04) - 521(1) I . 000199 a Regional Director Review Page 2 I iiji? Not Supported Cantinued Segregation Comments 2 CL Suppoded . mi See. ?ia?wb??w - 3c) aka? 2 Jo . mfg?: 1-901 91? Date Name of Regional Director/Designate (Print) 606%? ?y-?wc Sig?ature of Regional Director/Designate ?56 glee. 12/02 110/?- Dale Supplementary Report for each Subsequent 30 Day Period (Use bottom of form for additions-I comments - Comments . ignature . 12/ all 2617? <9 9W Continued/Additional Comments by Superintendent/Designate Dale Comments Signature Jug,me v0:? to, I 2? fut/mauvu .43.. I 03. 7/57 I 5n (A0 UM \Q?izmvmas VDWUF I I Laval," Contirtued/Avciditional Comments by Regional Director/Designate . Comments' Slgnalure Dore i- . (230 075?100 (10104) - Distribution: original - Regional birector (Onrr for Regional Outedor?eviow) .0 Copy - trunan File 000200 1 01W or Community Safety and Correctional Sen/Ices I . Central East Correctional Cent 9 Name (Last. First, Media) 1 A \Cllenl Identi?cation No. I Reasonm for Segregation 1 Date of Segregation Protective Custody Institution Security Medical Inmate Request 10/17/2014 Inmate advised ol reason [of segregation inmate advised of opportunity to make oral or written submissions inmate advised oi Opportuntiy for Interview With Superintendent Inmate waives opportunity [or interview with Superintendent Name of Superintendent/Designate (Print) - 4 Signature of Superlnt ant/Designate Data McWhin'nle mag? .9 10/10/2014 Superintendent DECISION (This SQCHOH must be completed within 5 days or the Inmate?s placement/?n segregation) InmateSubmleslon . I . - inmate requesting to go to a regular unit Superintendent Decision CI Release lrom Segregation Continue Segregation Reasons: Subject transferred'in irom CNCC. Behavioural issues placed on administrative segregation- Name of Superintendent/Designate (Print) Signature of Superlntend Designate Dale v?Tb I S. McWhinnie I - 0 10/10/2014 Segregation Review (Inmate's segregation to be navien/ed every 5 days. Interview with inmate to be conducted eve/y 30 days) lmnmeSUMnH?on . - Decision Release from Segregation Continue Segregation Reaeone: . . arc/Um? - ?gcxwotvj Luv/Laur (at/KI Name or Superintendent/Designate (Print) . Signature ofSupe i tandem/Designate Date bM?LQl?tiptuie, Smung wee/4 Supplementary Report for each Subsequent 30 Day Period (use reverse for additional comments) I Comments SuperlntendentIDeslgnate Signature Date .MNMk?ngy 075-100 (10/04) s.21(1) 000201 cantral [East Correctional Centre Inmate Smelesion for '30 Day Segreation Reviews Inmate Name: i OTIS Number: Inmate written for 30 day segregatlon revlew: MC (Eomrr?ICM' A/a Inmate Oral Submission fer 30 day segregation revlew: (To be completed by'Segregatlon Manager) gig/94.14.2041 C?oonL - 4' .7 i lhmate'signature: UWM - Date; -, Witness Name: ?57'br-7rw'gxg . - Witness Signature: I Hr.) amend) 521(1) 1 000202 2.9 Regional Director Review A Page 2 Continued Segregation Supported . Not Supported Comments 3 Il?i .CNCC Name at Re tonal Directortoeslgnate (Print) I Signature of Regional DirectorIDesignate Date. 4w [?m?rhuf (W /z for ea?ch' Subsequent 30 Day Period .(use bottom of form for additional comments Comments . jitgnalure Date . J, Continued/Additional Comments by Superintendent/Designate Comments Signature Date . . A 0b J?O??Wroom, 6/1 . Mom - Wwoa it) w- my 0- 2?7- Q- m4 L, gq4vKJL/l - :3 (gr. vat/Li {ll/Mig?L ?E?-Fa?cm . Must/14 - i A 'M?u?pth-K ?0 mm ?Anna-4 . puma-:3 I Huck Gaowm'??WM 7 11.11.14. W4- ch \g 'm Comments by Regional DirectorIDesignate Commenls Signature Date - 1 . 33 Lo gov. couarx. Origin! Regional Direct! (Only for Regiment Review) Capy ~11!?an Fiio 080 075-100 (10104) 521(1) 000203 6?36 . I 3? Minisw ?fc?mmumwsaf?ty Segregation Decision/Review . - and Correctional Services nerro - . Institution f3 I I Central East Correctional Centre Cilentldentiticalion No. . Name (Last. First. Middle) Reason(s) for Segregation . - . - . I . Date of Segregation Protective Custody Institution Security Medical Inmate Request 101150014 Inmate advised of reason for segregation, - inmate advised of opportunity to make oral or written submissions inmate advised of opportunliy [or interview with Superintendent Inmate Wait/es opportunity for interview with Superintendent Name oiSuperintendenUDesignate (Print) 5? ohm of Superi ndentiDesignale 7 Dale S. McWhinnie - -. 7 10/15/2014 Superintendent Decision (This section must be completed within 5 days or the inmate?s placement in segregation) Inmate Submission Yelling and banging and covering window Superintendent Decision Release from Segregation Continue Segregation Reasons: Bizarre unttsualdand aggressive behaviour - To remain in segretation at this time - special handling precaution initiated Name otSuperintendent/Designate (Print) 9 attire ofSUperin ndentlpesignale I Dale 8. Mchtinnie (AD man/to? . 10/20/2014 l' Segregation Review (inmate's segregation to be rat/revved every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission (ha/o LL, v/C/zr.l/t? m3 I Superintendent Decision. CI Release from Segregation Continue Segregation Reasons(Ur-Acting I - (Loire/1.1.4 at ova-0&4" WC, 0J1 {am/047.? +0 . (m armct' 4(?714? (?at $81170 0?0 (W reign/L #072417 Liv @?ax?C/E 0.33 we: Ewe. Quota Name?of SuperintendenUDesignate (Print) Signature atmate Dale ,[0:25.14 . i I I Supplementary Report for each Subsequent 30 Day Period (use reverse (Efrem: for additianetcomments) Comments Superintendent/Designate Signature Date - MMIddlm cso 075-100 (to/04) 521(1) 000204 Regional Dii?eotorReview Page 2 Supported El Not Supported Continued Segregation Comments 2 I Bimrtw. mm?m ll'kg Cyrr-mn. Name Regional DirectorlDesignate (Print) Signature of Regional DirectorIDeslgnate' Date War-Hr: {2/02/16 {9 a bottom of formlor additional comments} Supplementary Report for each Subsequent 30 Day Pet-led (us er?s - - . lure Date (J, f? - Wax/2W Date ContinuedIAdditional Comments ly SuperintendentlDesignate - Comments - Signature Mldewa 5 ec?wu/fmwfii?ej obit/r) 7:019 db fat-'30- i Hm We?! Lei/vim 41? - and? OLUIL 5/2th I: Adi/(4 . ?ared (urn 19.4% 7341 9/44/ and ban-Lung - A Muw- inchda?? wk) of? {oi R. Saw? bai'zaniOLL/p :5 3? r9 i :3?ng M43- Winch'Lu. ?5W?3t Ba?u? 2 MW . ?it Mi?mmc? iyo?lq- 3 \CtTapl-rurUI?um 37?1"? 'n's'iule? M. +04% let mamgmm la.er 12%?ch Let oat we tame. Continued/Additional Comments bLRegional Director/Designate Date Comments i Signature Um Let wiggle; Jam-l, 331'. Diglribuuon: origin] ch?mal Director (Gary IorRegioaarmedar Review} Copy - lnmalo File - 080 075-100 (10104) ame) sun) exam) 000205 la la ?i ?1 if) Ontario (any Ministry of Community Safety and Correcllona. Services a Segregation Decrstoane?vrew mt mental-1L1 0L Q?entral East Correctional Centr Name (Last. First. Middle) 1 .3 Client identi?cation No. Date oi Segregation 1 0113/2014. Reason?ts) tor Segregation i ?e Protective Custody Institution Security Medical inmate Request Inmate advised oi reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity tor Interview with Superintendent Inmate waives opportunity tor Interview with SUperinIendanl Name of Superintendent/Designate (Print) sgnum of Superimgnaie Date 3. Wt CUB 10I1512014 'Superintendent Decision (This section must be completed within 5 days ortne Inmate 's placement in seqmga?on) Inmate Submission . - inmate states he did not get along with other inmates SUpErinlendeni Decision Release from Segregation Continue Segregation Reasons: . Subject admitted to segregation after being run from his unusual/bizarre behaviour referred to Name Signature otSuperi doniIDeslgneie - Dale 3. McWhinnie 1011512014. Segregation Review (inmate's segregation to be revIeWed eVery 6 days. interview with inmate to be oonducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation Continue Segregation ?1 . - 9380M y_ 04, .W WmocpyL (.1 e/ (om-{u Name of SuperintendenUDeslgnate (Print) Signature of SuperintendenllDeslgnaie Date 3n0?u3ttmtur5 logo-r6, Soppiementary Report for each Subsequent 30 Day Period {use reverse allow for additional comments) .v Comments I - - SuperintendanUDeslgnaie Signature Date . 030 075-100 (11mm - 5.21 (1) kw 000206 Rgrlionai Director Review Page 2 Conlinued Segregalion Supponed El Cornm?nls I Nol Supporied Name of Regional DirectorlDesignate (Prinl) Slgnalure of?egionol DlreciorID algnele Dale ?20? @1me - - Jz/o'L 'Lorcf Supplementary Report for each Subsequent 30 Day Period (use bottom o?grm for?addi?ona! comments ?aming [If Signalure Dale A . I, - 7 - 'ConlinuedlAddilional Comments by Superintendent/Designate 7 Comments Signature Dale 7 1? .. B: arr?. [145099; wmab?a . Luna? (on, on? Lose?? W562- u. vachL Luh?n aw page . +0 - -Z.q . ISL 8? wrJ/naJe?J 1?1) volbuwaw?? ma. 14- war/{SWW if! ?Wilt/- 6 Continued/Additional Comments byjegionei DirectorIDesijnai Comments Signalure Dale Mir/am Drughal Regime! Dirador [Only forwa Copy - lmulo File cso 521(1) 000207 Ontario ?Fin/Piggy; Ministry of Community Safety and Correctional Servlces Segre ation Decision/Revie l? it 33-104 Li- D: - - Reason(e) tor Segregation 7 - ?1 \n - - Central East Correctional Centre Name (Last. First. Middle) Clienl Identi?cation No. Dale of Segregation 17 Jul 14 Inmate advised of reason for segregation Protective Custody lnstitutlon Securlty El Medical El Inmate Request Inmate advised of opportunity to make oral or written submissions Inmate ?firmnin (or interview with Superintendent Sgt. K. Staffers Etnmate advised of opportunlly for Interview with Superintendent Name of SuperintendenUDesignale (Print) up man ntlDeslgnate Signature I 1 Date 17 July 14 Superintendent Decision (This section must Inmate Submission i?Superintendent Decision Admitted to segregation by TEDC - non-compliant and assaultive in Placed on special handling Release from Segregation 'be completed within 5 days of the inmate's placement in It CTnlinue Segregation igregetlon) i I Reasons: VMM i i . awni? grunge? ?iv 9-?er \w ?Alan-a vmme em - Nameof.SuperintendenUDeslgnala (Print) Sta-'1? 14. gTo?cm Signaturwndenuo aislgnate Date . i . . i Segregation Review (Inmate's segregation to be rewewed every 5 days. Interview With Inmate to be conducted every 30 days} Zi/TuL/lcf Inmate Submission i I Superintendent Decision Con'linue Segregation Reasons: Release from Segregation behautowb km Lu eleg- 4e CI U?c?d cit/u? - mi ?title; ?limo? euro. . Name of Sunerintendent/Destgnate (Print) Signature oi SUparintendenUDeislgnale Date SMUORMARL (- Supplementary RepOrt for each Subsequent 30 Day Period {use reverse olform foradditlonatpommants) . - I Comments SuperintendenUDesignale Signature Dale - MMIddIyny 521(1) I 080 075-100 (10104) 000208 l5 tat Regional Director Review Page 2 El Supported Continued Segregation Not Supported Comments Name of Regional DirectorlDesignale (Print) Slgnature of Reglonal Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments 4 Wym? Date .r . 91.40- 7AM cam/w Continued/Additional Comments by Superintendent/Designate Comments Signature Date CW1 add/2th rL Mt: hadioLL/L, um 3? w? ~9me (a2 Oslos'llit-l' Swat-E? Dial-:5: 0'1 c.3\ gtugqi A \Im (L - th o. enemy?toxe M1 at m, (it Vm?g ?13 ka? ??LchJ?b A I a.ka - U-w?b w1?aubLL girl W5 tws?iur?vi I tasth og/lg/lkf, Continued/Additional Comments by Regional Director/Designate Comments - Signaturel Date . s.NlR c: 91(1p n: Original - Regional Director {Only for Regional Director Review) Copy - Inmate File C5D 075?100(10104) 000209 i I Central East Correctional Centre Inmate Submission for 30 Day Segregation Revlewe inmateName: OTIS Number: -J Inmatewritten submission for 30 day segregation review: Inmate OralSubmission for 30 clay segregation review: '(To be completedlby Segregation Manager) Inmete signature: Witness Name: Sheena Witness signatureL'Sm Date: i i i i I Agatist16L2014 521(1) 000210 Regimen DIre?torRevleW Con?nued Segregation SUpponad Supponed Page 2 Comments Ma? f..ng I 14% Wk 0 n-mRKA-c mL ml?l?a?. m? Name of Regional DiredoU?Beslgnalc (P?hl) Signatute of Regional r. Supplementary Repart fo'r each Subsequent _30 Day Period (use bottom offOrm for 'addMonaf dominant: Dale awry/law Comments Dale MMldem Mi: I 40270 .444 atsaA-Q- - ContinuedJAdditlonal Comments bv superintendent/Designate Commean Signature Date Mkbh'i?f) haw-x ?ad'?hwdm'fb 53m. I ?E'V/oLl/m? ?lm 5:1: cam-A . Ed: hugg Ex: 33.0.9.0 .- 0630 oi. A - tag .?Im d. . . ?ouvl- nkrum LA L71. if amok mmpf?ak2cr??bb uw?buzlta??a a? I 03109114 Lyn-133% Cbn?nued/Additional Commenir. by Regional Director/Designate Comments Date . . 5721(4) cs0 aumuom . Copy?Imus Flo 000211 Leta 5'0 6C Regional Directo'r Review Contlh?ued Segregation Supponed Comments Page 2 Not Stipported Name of Regional DirectorIDesignate (Print) Slgnature of Regional Director/Designate Dale i Supplementary Report for each Subsequent 30 Day' Perlod {use bottom of form for additional comments Comments Signature Date 07 MM/ddmg (WM/bet 4 . . Continued/Additional Comments by Superintendent/Designate Comments Signature Date Beak. oa- hw? 03/22/141 (o r/m/up 6" %m Bettina-ha. W. (q the.? . . aging/Ix; 69/05/15? ?bukmv'twv? asguiu-J?R mac-?- ?h gwow?v cal-?1 fC-QH-A-?b?ifN-b- Md" It ad kc)! LIL Janv . Continued/Additional Comments by Regional Director/Designate Comments Slgnalure? Date L?o -m m'tqu?bgW/ Elam-b a-J \smhxaur?xow aflov??c, 4 - .AMG. mA 131% oat/Np? ?owed 511(1) 075-100 (10104) oung Regional olrowx (Only for Regional ?imdorRavbw) Copy - Inmate Filo 821%!) 000212 Page 2 Ramona] Direclor Review C-onlinued CI Sgpponed i Nol Suppoded Commenls - - ~i . Name of Regional DireclorlDesignale (Print) Slgnalura of R?glonal DlreclorlDesignale Bake 5 I ReEorlTor each Subsequent 30 Day Period (Use bottom of form for additional comments) Commenls Signature Dale . - I i . . MMiddinW .WI mg) - - I /0/9g lL/ [0644654 my ?3.14 JM 414; i ConlinuedlAddilional Commenls by SuperintendenUDesQnale . Comments Signature' Dale . I - . th'buaol AH'Luan. 4. I (5?3 $630; \mgrasrcmem?r oq 65.39% Egg): VOWLJL 4k ?l . \Lm. . ?cow Dl'1 ?10 'Lv- J?m- I I I I 715- 'Mb?m . u0us a! - (gamma Mm . 62" Qvougw com I i I I so I- Unwed ?3th\ 09/3011 54? Lo?s??mw 1 . I IDI/agjll'f ContinuedlAdditional Comments bLRegional Director/Designale Commenls Signature' Dale - I I I I I: I Jamis- I My ?011 raj/4. Lthu?uAg '5 \D'I?Lanti e. I GA A ?319.14; I 0% wk - Aw-vr . Wane Odblnal - Regional Diraolor (only In! chiunaI-Dimcfor (7:301an . Copy - lnmala Flla - I i 030? 075-100(10104) s.NlR- s.21(1) 000213 ?iS be [05. L. Regional Director Review Page 2 Continued S??agalion Supported Nol Conimenis ac) . \Deo?w 3303m53 ?3 QLU Name of Reglonal DirectorIDeslgnale Signalure of Regional DIreclon?Designale Dale @04??a-mwc . Sugplementary Report for each Subsequent '30 Day Periedjgse bottom of form for addiilonai comments . anaiure Date I 1 Mia/dam Continued/Additional Comments bLSuperlntendentlDeslgnate Comments Siglnalune Dale 5 La. . UL Mdelmyr 0mg}. Lyme-3m ?or ?ainq gaff/nut; I wig/1F Iii-hat; - Wmu'm'm on A 25 [hf +0 GAN- Lana?26' I panama/6 9?0 wudf?c?m I Jwr' 01/ a 33% Mot/imi- MMJ- cum. growl] 'fu apatite. +0 43W 0% #51 min?L Mil/1.5" ,0 41w+ we ricm 0Lch We I . I mpime- 0c is 03%. 1:90 LUNA ?Mt-hm Continued/Additional Comments by Regional Director/Designate Comments Signaiure Date I MMIdd/yy? Dismbullon: Drighal - leonai Dlreclcn' (Only Raphael ninety Review) me-lmmtoFila CSD 075-100 (10/04) 521(1) a- ?usr21(2)(? 000214 twig Mlnletry of Commonity Safety and Correctlonal Services - - - tee-awe imam: Segregation Decision/Revigw .. ,insti?tionTWW. W, Central East-Corieclional Centre\ Name (Last, First. Middle) Reason(s) tor Segregatien I Protecltve Custody Ci Institution Security El Medical Inmate Request 3/ Client identi?cellon No. . I . Date or Segregation - 15 Aug 14 .lnmale advised of reason tor segregation inmate awed oi opportuntiy for interview with Superintendent Inmate advised of opportunity to make oral'or written submissions Inmate Walues opportunity ['or Interview with Superintendent Sgt. K. Staffers Name of Superintendent/Designate (Print) Signature of Super De gnale Date 13 Aul?M Inmate Submission ?t/M admitted from '3 pod Superintendent Decision (This section must be completed within 5 days of the inmate '3 placement in segregation) - allegations of'muscling on unit Reasons: Superintendent Decision Release from Segregation E4 Continue Segregation Name at Superintendent/Designate (Print) Date Signature 0! SupeWte 03/23/171. Inmate Submission Segregation Review (inmate?s segregation to be reviewed every 5 days-(interview with inmate to be conducted every 30 days) 1x [j superintendent Decision Release from Segregation [3 Continue Segregation Rea son . LL \lt?h . Name at SuperintendenUDesIgnate (Print) - each Subsequent 30 Day Period (use reverse of form Slgneture at der?UDeslgnale Dale 01/0! 1% - . I . Supplementary Report to Comments SuperintendenUDesignate Signature Dale can 675-100 (16104) .s.21(1) 000215 Page 2 Re ionat Dir?ttor Review . I - Continued Segregation Supported El Not Supported 41 . - Name oi Regional Director/Designate (Print) 7 Signature of Regional DirectorIDesignale Date Supplementary Report for each Subsequent 30 Day Period Jase bottom of form for additional comments . Comments . Signalure' . Date Re ac. . I.- .- Auk) I r0 . 4W emerald? 0* tm'b?hrwr wn~ Continued/Additional Comments by Superintendent/Designate . - 1 Comments - Signature . Data - i - a'o lung? \?D-?Mnm anximk.? 01/00,, 96 oblong/NI I Milli Adur?mra?A tau-x "m chi-QOL - . . "newea?m twang out, the, . . a ContinuedlAdditional Comments by Regional Director/Designate . Comments - Signature Date 5 33/ (Ramxm ?41,335 hm .- cum/xi? I - . Original - Regional Directo?OnJy (or Regional Director Review) Copy - Inmate File cso 075-100(10104) s.21(1) 000216 Page 2 Re?ianal Dliecto,r Review 0 - .Conlaned Se te a?on Suppongd ll No?Supponed 2:0 . Omig?bmfw Win - I Name afRE?lonal Erector/Designate (Pdnq? - Signature of Roglon?l 'gnate Data be?nf oy/aaluma Supplementary Report for each Sabsequent 30 Dav Period (use bonom'offonn for addh?ional co?mments Commentu Signature Date 30 Mdem N04: mWi-D YMpuq. Ref-3% - '1 . w?ulm brawl-ba?sstm p7 -. - I rwov'v Hf:an ml hun- SuParintendenUDesigrEte . 'Commom - Wig/kg; Signature Dale JIM/dwij L4 M, O?Mcw 135 .(uth 'Uw A I ..L 7 . Continued/Additional Comments by Regional Comments Sign'aturo Dale . [WM/dam ?W?v mg? 0 Dhmbu?m: mom! - Regional Modal armor Raving (:80 075-100 (10104) s.21(1) 000217 Page 2 I . kbistrict Administrator Review Continued Segregation Supported Not Supponed Comments Name at District AdministratorIDesignate (Print) Signature of District AdministratorIDesignale Dale . SuPpternenlaw Report for each Subsequent 30 Day Period (use bOttom of form for additional comments) comments .. Signature . Date . 64,72 . Continued/Additional Commentsg St?aerintendenUDesignate Comma . I Signature Date . - 3FiJKt-7lgoam 3.40 11? 1? 99PM. ?Mac/x4 Cmnut RMCa/vn? Rafa/?Jo I . 6o Tam-t, Art-won to :Fpgfiwo to cage to I ?boa/cf. mow ?Mb . - 29/; . KB rRzmu??M? 3M tinJuub ad9906 r: ?2121th . 40 c?t?w/L . LI. Continued/Additional Comments by District Administrator/Desi nate Comments I Signature 7 I - Date 0 jo'l?qg . A Mammy? . Dialribullan: Original - District Mninislrator (Only Inf aura Administrator Review) Copy tomato Fits I CSD 075-100 (10/04) 5. 521(1) 000218 I r. ?53962 District Admi?istrator'Review Sugpo?ed N01 Supported Cl Continued Segregation Comments 90 max 95? Q?cauesf - Nag-t) 6:065.) CHMCETS Guc- Sugnuasxog Dale Name 0! AdministratoriDeslgnale (Print) a: Signature 0! Dislrid Administratormeslgnale ?f??mod? Supplemenlamort for each Subsequent 30 Dry Period (Use bottom of for-additional comments omme ijsignature DaIe - MIwadm ZJN Continued/Additional Commenis'by SupEriniendenUDesignate . Commenis Signalme Dale . ?1 I I ?5 . Mum?K 3 C?xm ?~31be day's???hi/L - .MNM . QMW ow SLR \mmiE?JvaJ4m 2/2. 1" 1551")? ContinuedlAddilional Comments by DistrictAdministrator/Desi nate - 7 - Commanls Signalure Dale l? Dlembullon: Origina! Dismal (Gary District Adounislmfor Review) Copy - lnmale Fire S. cso 075-100 (10104) 000219 Ontario Ministry of Community.'safety and Correctional Services Karly - Segregation Decision/Review it we: Institution 131-4 LNG '1 Cel. rai East Correctional Centre\ Name (Last. First, Middle) Client Identi?cation No. hm~ - Reason(s) ior Segregation L. i:i Protective Custody CI Institution Security Medical Inmate Request Dale of Segregation 23 Sept 14 inmate advised oi reason for segregation inmate advised of oppoitunily ior Interview with Superintendent Inmate. advised of opportunity to make oral or written submissions Inmate waives for Interview with Superintendent Name of SuperintendonUDesignale (Print) ,Sgt. K. Sto'ffers Signaltire oi Wesigmie Date 25 Sept 14 Superintendent Decision (nu's must be completed within 5 days ofihe inmate?s placement In segregation) Inmate Submission . had recent knee surgery - medical El Superintendent Decision . Release from Segregation Continue Segregation Reasons: Mew-M messed - Name of Superintendent/Designate (Print) Date oq/z?t/Ihi Segregation Review (inmate's segregation to be reviewedevery 5 days. Interview withiinmaie to be conducted every 30 days) Inmate Submission All :19 Superintendent Decision Release from Segregation Continue Segregation Reascins: iww .- Name of SuperintendenilDesigneie (Print) Signature of Supe?den?3esignate Dale Supplementary Report for each Subsequent 30 Day Period (use reverse of ioml'i'of additional comments) io/o?s/ILL Comments Superintendent/Designate Signature Dale CSD 075-100 (10I04) gts21(2X? siWR sAzuzxd) 3210? oboozzo Page 2 Regional Director Review Continued Segregation E: Supperte?d . Not Supmrted Comments $0 :5 Mama? Name Slgnalme oiRegionalDirectorIDesignate . Date ?24; Epm?c n/o?/zo/Lr Supplementary Repon'for each Subsequent 30 Day Period (Use bottom of form for additional comments Commean 1 Signature Date a . 1 Mdefmy on MILL 0 Ag he CJHW Voting Jtt?Lbl?mmrm mutated a 8 [0/50 Continued/Additional Comments by Superintendent/Designate i - Comments Sig I Dale . i I i WW We \Im ijxM M'Mkr mgakhug, immuni'iws 1 ?ay-51 FemH-m or 4.00 met-clove - misting/de Continued/Additional Comments by Regional Director/Designate . Comments a Signature Date Distribution: Original - Regional Director (Only for Raphael Director Review) Copy - lnmala File 5 . NI 030 075-100 (10/04) s.21(1) 000221 .Centrel Eeet Correctional'centre Inmate Subrnleelon-for 30 Day Segregation Reviews ?nmate Name: I IOTIS Number: 'In ate eeb' ss?l nfor 30 da 39 re atlon rev ew: kn?- . 3-9 . Inmate OraI?SubmiesIon for 30 day segregation review: I (To be completed by Segregation Manager) Inmate signature Date: __O_ctober 26. 2014 W?tness Name: A. Wltness Signature: I s.NlR s.21(1) 000222 I I I 1 I Ministry of Community Safety . $99 and Correcti0nal Services; I . Wei-n r?egation Decision/Review - Ontario . )nstitution A r" _Centra'l EastC Lg . asst;- Lt (In . . arrectional Centre - Ey? Name (Last, (First. Middle) Reason(5) tor Segregation i I. . Protective Custody i:i Institution Secwity Medical Inmate Request 5 Client Identi?cation No. .MM 12/17/13 Date .of Segregation Inmate advised of reason far segregation Inmate advised of opportuntiy tor intewiew with Superintendent - Inmate waives opmi Inmate advised of opportunity to make oral or written submissions for interview with Superintendent Name of Superintendent/Designate (Print) Si nature of Superinte de UDesignate Date 5. MCWhinnie MD 12/17/13 Superintendent Decision (This section must be completed within 5 days of the/nmate's ptacernent in segregation) Inmate'Submission - Request to remain in segregation Superintendent Decision 5- Release from Segregation Continue Segregation Reasons: Inmate request to remain in segregation for protection Name ofSuperintendent/Designate (Print) nature of Superinten taint/Designate Date II S. McWhinnie 12/22/13 Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be ?onducted eveiy 30 days) Inmate Submission . Requests to remain insegregation Superintendent Decision Release from Segregation Continue Segregation [3 Reasons: Inmate Request - inmate request signed and placed in ?le Name of Superintendent/Designate (Print) 5' nature of Supen?nte de UDesignate Date I L. I s. McWhinnie i i 121mm Supplementary Report for each' Subsequent 30 Day Period (use reverse/afform for additioan comments) Comments - Superintendent/Designate Signature Date .MM/dd/my I i 030 075?100 (10/04) s.21(1) E: 000223 Regional Director ReView -Su9poned 'age 2 ContinuedSegregetion - Comments i iNot Supported Signature'of Regional Dire ctor/Designale I Name of Regional Director/Designate (Print) Date Supplementary Report for each' SubSeouent 30 Day Period (use bottom of form for additional comments Comments Signal ire Dale Continued/Additionel Commenfs by Superintendent/Desig'nate Comments Signati re . Dale Wm . ?in; Lch-x - I (Di/611114) 8 WSW 30 oil/i 3; in?ll/mgr; recs?QM SWEDM <5 Cali/gm ol/zi/?? i {if in.th Balm/w i- i owed/cf g) [roman-ta religW?FO PM a, Continued/Additional Comments by Regional Director/Designat ?ll/i algae/M Comments Signature Date I 321(1) Distribution: Original - Regional Director (Only for Regional Director Roviow) Copy - Inn-lam Fila 030 075-100 (1 0164) I i ?Int?Jr 000224 Regicinal Director Re- I Continued Segregation Comments I Supported Not Supperted- Pagefg Name of Regional Director/Designate (Print) Sig nature of Regional Director/Designate Date Comments Supplementary Report for each Subsequent 30 Day Period (use bottom of ?rm Date Agreed 1 WW lea/Mn Lit 60 - - ContinueafAdditional Comment! by Superintendent/Designate 101/ ?7 Comments Signature Date lwv?kaiQ ?49m wech 60 tin?MW $44: -, ??wgwx?ww ?5.2a - Dime? 3-H ?iidUw ?94 \i'gmmh rye/bitumi? oa/aa/lgl 40 grimb 76 ha. raw 80 immt?' Fae?9M6 cal/Me 05/07/11 Egg Iime Few/Q (2: 4% +0 90 \E'Muwe {(12 yum. MG, . eye/i if Continued/Additional Comr?'ents by'Regicihal Director/Designate Comments Sig nature Date 91(1) Distribution: Original - Director {Only for Regional Direclor Review) Copy - Inmate File CSD 075-100 (10/04) 000225 . Regidnal Director. Revie?w 'Page?l - vi Continued Segr_egation Supported Not Supported Comments - - Name of Regional Director/Designate (Print) Signature of Regiqnal DirectorlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form f5r comments Comments 'j Date if) . 130 Wmfko-?b?b git/W hum/mm w. - W.t9mw.ao+in L112 ?06 \vxmoJLa W?t? not My raj m? *y OWHPLE roulc u. Au. - 01.0% mm Continued/Additional Comments by Supenntendent/Designate Comments - Signature Date . ,mm . at; 05/Q5/ll?i WW 'Mrw 8m 05/30/14 imw- Wag-l? oLl/o?ir/ltiz ?5 inmate Mara-eat I lgohxwwaia M5 Irv? Am. 'aQSovgu'c kpr?olvb nmwokmlm+ (AF. QM- 04/19/.Mv?ycp - - . 7 Continued/Additl?bnaiJComments by Regional Director/Designate - Comments Signature Date i S.NIR 04l4? am I 'l CSD 075?1 no (10104) - Regional Director (Only for Regional Dimmr Review} Copy - Inmate File 000226 Page; . I - 9 Direct'or Review . Continua Segregatlon Supported Not Slammed . Comma - . ?an Ira; with.) paw muf?ed?? . Name of R?ag?ona) Dlreqorlo?slgnam (Pn?n? Sign-alum of Regiorhl Dirador/Deslynal?' - Dale - . QM @1wa I ?15m . dS/aU/ZalV Supplem?ntal?epon for each'Subsequent 30 Day Period (use bottom offer ditionaf comments Commenls SI 70 Dale [0 4o of, I MMIddlm I50 lama: .Agc Q-I- bk - romoh- 0 mka . 06mm} Continued/Additional Comments by SuperintendenUDasignata- Comment-.1 - - alum Data A Mdelymr \30 lama-It: (?Bi/ham Lr?? I 04,261 i I I r0 I ?fe tuxth Life lgrow?o rmtca a was OS or A Luca: aims/rue! - ContinuedlAdditional Comments. b1 Regional Director/Designat 9 Comments Slanalure Dale NIde - 521(1) 5.4 Ham molnbu?m: 0min! 4mm Morle fur-?th umw?em Cow - inn-Lula ?le csDI 075.100 (1DIO4) 000227 A Page ii) . . i. (0 Regional Director. Rewew Continued Segregation Supported Ci Not Supported Comments - Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Supplementary Repon for each Subsequent 30 Day Period (use bottom of formg ditionel comments Comments Si 711;! Date I all 06/165114. 150 inmiomc' I - rot/.oQ ogpmiwmivu km eme- i/ amok. gp- 3- qu i Continued/Additional Comments by Superintendent/Designate . . Comments Signature! J10 ?f"i?D Whiz/W - 8? [mm?s . - Moqu ace 2'4"th - 40-cuppa, 47,) Met a. oS/ier/ni A?q ?i?oul'VQ A at LL;in - [SS/nma??v Wag/1:. Emmi 6/29/14 Continued/Additional Comments by Regional Director/?resignat Comments Signatore Date S.NIR - sin Dlurlbuuian: Original - Regional Dlreclor {Only for Regional Director Review) Copy - Inmate File cso 075-100 (10/04) .a 000228 Regional Director Review Page Continued Segregation Supported Not Supported Comments Date Name of Regional Director/Designate (Print) . Signature of Regional Dimmer/Designate Supplementary Report for each subsequent 30 Day Period (use bottom of form for additional comments - Comments i Signature . Date ((owl? Haw m- eewaw- mm mosswh- mdm?hmwn f/Igl/?? . 01/29/20? Continued/Additional Comments by Superintendent/Designate Comments . . Signature Date . MM/dd/ymr [I'Lme 1?0 FEMM w?i Jr (4/3/sz Pro (aft/[l LL cam/21? ?We at, c. a4 kamku-x ContinLTedlAdditional Comments by Regional Director/Desi?ate Comments Signature Date Olat?butlon: Original - Regional Dlrector (Only for Regional Director REVIEW) Copy - Inmate File (:80 075-100 (10/04) 521(1) . 000229 Central. Easi; Correctional Centre Inmate Submission for 30 Day segregation Reviews OTIS Number; i Inmate Name:- I Inmate written submission for 30 day segregation review: <53 EM Inmate Orial Submission for 30 day segregatidn review: 1 (To be completed Segregation Manager) . i . )m am.? ?15m? mm u?m?cg 7?7: iAUngee. S2470 ngdaugd Ag . 40 at?lvM?Si?fz?va Jig/1'ng I I Inmate signature: Date: . .- Witness Name: 8 18%? Witness Signature: - 521(1) 000230 Central East Correctional Centre - . Submission for 30 Day Segregation RevieWs I Inmate Name: OTIS Number; Inmate writtenisubmission for 30 day segregation review: I an no A Inmate-Oral Submissionfor 30 day segregation review: (To be completed by Segregation Manager) - Inmate signature: Date: 2014 A - - s.NlR Witness Name: Sheena McWhinniem a Witness Signature: 821(1) 000231 Regional Director Review Page 2 .ContinuedSegregation Supported El th Supported Comments 1 Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date I0 7 757 Am (Mle [?rs Mondays/mo GIG. a! j/lgj/?l mica/e371 r'm ammo nose-G. 3/2 ?3/1'1 Continued/Additional Comments by Superintendent/Designate I - Comments Date inmate @M?sh rtmain 7/ are/ML ?1,3ch4} - 7r// lan m: homo?; Mm 9?0 Au: 7/ owl/24L I 36 A?)th . ?i o?lJze/iv?i modqohvaeContinued/Additional Comments by Regio??al Director/Designate CSD 075-100 (1 MM) 521(1) - Distribution: 069mm Regional Diraclor [Only forRegionol DirecI'Or Review) Copy - Inmate Filo 000232 - Page 2 Rggional Uir?ctor Review 2 Supported CI NotSupported Cgmmenuj. 33:0 may . 5w: nuance-A Dat 14Ito/(f? Supplementary Report for each SubSEquent 30 Day Pen?o . formradditiona! comments Comments Signature Dan: . 3 .5 9 [Ma r?fLma?l-v? do MW - 7 4 .Aul'bmgs I . Continued/Additional Comments by Superintendent/Designate - 'Comments Signature . Date bran-.132 - - Con?nued/Additiohal Comments by, Regional Director/Designate Commehu . Signamre Dal: Dian-inning 0.1mm: -Rouion:u ?rmer (My Cay - inmua Flu IR 8. can s.21(1) 000233 Central East Correctional Centre Inmate Submission for 30 Day Seregation Reviews Inmate Narne:_ en's Number:_ . Inmate written submission for 30 day segregation review: . Inmate Oral Submission for 30?day segregation review: . s.21(1) (To be completed by Segregation Manager) 5 21pm) Inmate signature Date: August 1 7. 2014 Witness Namez' Sheena McWhinleie I - Witness Signature: 000234 Rgegiona'l Director'Revit?w' Page :2 ContinuodSegregatiOn 7 UL Supponed Not Supported Comments V. Jot? .. 1? Name of Regional (Print) -. - gnate Dat -- -. Mir/4%: . I I . I Supplementary Report for each Subsequent 30 Day Period (use??attom g/formgradditionai comments) . - I Comments Signature - Date - - murder/my limbrmx-gd Continued/Additional Comments by Superintendent/Designate I I Comments Signature Date I - . w; . A nmc. away-H - . I . mm? 1.4124 . a; hos/zz/ ?5'39 waif/4 I ?lm?s-4J4? 39$ . 4/52 m- n7e{66237) mlyg??; Continued/Additional Comments by Regpnal Dire ctor/Designate Comments Date C) I ?gimmick \ko - 5.14izua) 521(1) 5.2mm) Original - Regional Director {Only for Regional Director Review} 050 075-100 (10/04) Copy - Inmate File I 000235 i 4' . ?Regi?n?l Dire-mar Review page 2 an?nized Searega?on - Commons. Supnc?eq Not Sopponed r" I: . 25/114Supptementary Report for each Subsequent 30 DgzPedod ms addi?onalcommonrs Comments Signalure Dale MMldehyy ALLA Comments bLSuperint?ndenUDgignale A - 71%114 o?BJ/?a/l Comments smnaxur: Date -. muder 12) Merv . . I . :40 M7 ,w Ewe. ?E?ll?vL/l?f 4g A MIQQJQ -MA oyz?z?j [If . I 521. 12419-401741: km #1 ?579 Wan/M 164 o?lzo 95. "13 7? Warw- #3 an Mist I?gngM .11W?kj: . . I Comments by Regional DirectorlDesignate . Comments - (a -. gm 0 humus?: Mobil-Emmi:leva chb?? 501' uRen'm-a .631) 075100 (10/04) new a 1mm Fan s.21(1) 000236 "Regional Director Review (Son?nued Segreqa?on Comments Supported Not Supported Page 2 Name of Regional Director/Designate (Print) Slgnature of Regional Director/Designate Date - I I - Supplementary Report for each Subsequent 30 Day Period (use bottom of form fotr additional comments Comments 5i 'nature Date - wed-km oL alt?o.de Continued/Additional Comments by Superintendent/Designate I Comments . Si?nature Date . - . I 0 LI \lm \15 MLme Lab{23 Ere, 4; t/m W't?am vw 935 A 3 Ma, ?Wm/?f tm ?14:2- h? 5L0 ?gmew I - (340 amoawgelww 5; f0? 0?7? . . . . 945 tnmco Au ta (WW 90H areContinued/Additional Comment}; by Regional DirectOrIDesiLnate - - Comments Si' nature" Date -- remm to ramRegional Dlroctar {Om'y for Ragionar Director Hoyle-n!) Copy - Inmate File . s.NlR I cso 000237 Cantrell East Correctional Centre InmateSubmissien for 30 Day Segregation Raviews Inmate Name: OTIS Number:,_ inmate written sLIbmission for 30 day segregation review: inmate Oral Submission for 30 city segregation review: (To be completed by Segregation Manager) - in w" 4124. Datah?; b16142- cvm1-Man?VLQL. WanoQ not mkm-RbrInmate signature: Date: October 6.- 2014 Witness Name: S. McWhinnie. . . Witness Signature: 7 s.21(1) 000238 Page2 District Administrator Review . . Continued Segregation Supported Not Supported - Comments 334230 2W4- (m Name of District Administrator/Designate (Print) - Signature of District Administrator/Designate Date . r- ?lfolzottp Supplementary Report for each Subsequent 30 Day' Period (use bottom of form for additiona/ comments Comments Signature Date - 3310 (Le? uI/aaf/cl/ Continued/Additionel Comments igy Superintendent/Designate Comments -. 7 Signature . Date I . 3-0 we ?Web 4 7 - 0?5, I 3?70 (vb-CA Yak-013- 3?10 OLcu.? 6? - - 32,0 - . - act-339 dun-q mango.) And Now-Lo. 5 (30 app oxeo'uyb.) Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date Original - District 'Administrelor (Only for District Administrator Review) Copy - Inmate File CSD 075-100, (10/04) 000239 3?2 zgontario Ministry of Community Safety and Correctional Services Segregation Decision/Review pots Li {it -Instiiulion 18%qu East Correctional Centre Name (Last. Fir?sl. Middle) Client Identi?cation No. Reasonts) tor Segregation Protective Custody I Institution Security Medical Inmate Request Dale oiSegregation? 26 Sept 14 inmate advised of reason for segregation inmate advised of opportuntiy for Interview With Superintendent inmate advised of opportunity to make oral or Written submissions Inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of Supe?nele Date . 29 Sept 14 .Sgi. K. Stoiiers Superintendent Decision (This section must be completed within 5 days of the Inmate?s placement In segregation) inmate Submission involved in altercation on 2 pod - Misconducis- pending Superintendent Decision El -Reiease from Segregation it Continue Segregation Reasons: Cg (Adda Name of Superintendent/Designate (Print) 8 il/iuoi'immti Signature of Superintendent/Designate Date Inmate Submission I Segregation Review (inmate's segregation to be reviewed eVery 5 days. interview with inmate to be conducted every 30 days) 797C lg?lt/lq" Superintendent Decision Release from Segregation El 'Conlinue Segregation Reasons: [22? '41 nmmodkc?lz Name of Superintendent/Designate (Print) Signature of SuperintendentIDesignate - Dale u; Supplementary Report for each Subsequent 30 Day Period (use reverse orronn faraddilionalcommenis) Comments SuperintendentlDeelgnate Signature Date s.i\ilR Mde 5m s.21(1) cso 075100 (10104) 000240 339? Regional Direclor Review Continued Seqregalion Supported Page 2 Comments _3C:,cl? Inmate - Not Supported Name 01 Regional DirectorIDeslgnale (Pn?ni) Signature of Regional Direclo?Dealgnale Dale few! game-ll ?713, gJi [1/06/2119 Supplementary Report for each Subsequent 30 Day Period (use bottom of'form for additional comments Cammenls Signalura Dale 7 A ME) NW *Ctl'h? . WMnL?c-m; an 01433?8 Jingme/?f Continued/Additional Comments by Superintendent/DesignateL/ Comments Signature Date ny?X/zw - c?mhv?v?s All?4? - - '0 ?lm :mlt?snum 3:1: k2. mon- cmpbad?. 4 . (W ham-.3342. W- lo/Igpq,? Hm Mew Wacmpw (Lo-p GLFICs. th'i?fmaa? +0 Th) Win: (luv-x Ln}; (Thaw-? Mrvtowwi-??. W?mt?bm 9W1 I . I /0-26- Continued/Additional Comments by Regional Director/Designate . Commenls - Signaiun'e Date 5.14izuo) s.21(1) Copy - lrrnale Filo cso 075?100 (10/04) Oi alrlbullon: Origin! - 129ng Mean! (Only Regina! Diador?'aviaw) 000241 Central East Correctional Centre inmate Submisson for 30 Day Segregation Reviews inmate Name; I I OTIS Number: inmate written submission for 30 day segregation review: inmate Oral Submission for 30 day segregation review: (To be oomgieted by Segregati Manager) - 7514) ism/EATon - ?na?aw? Mac/?gin 054%. MC W?po?wda 661,6. - 1' inmate signature: CE, Date: October 26. 2014 Witness NameWitness Signature:. 521(1) 000242 .I - Ministry GICOminuniW 3379?? or" Segregation Decision/Review -- and CorrecttonaIServrces ,9 I - .- *iw?rrwium?r - 9 "mm. I I Central East Correctional. Cans Client Identi?cation No. Name (Last. First. Middle) Reasoms) lor Segregation I Date of Segregation Protective Cuslody Institution Securlty Medical Inmate Request 04,25,2014 Inmate advlsed of reason for segregation Inmate advised oi opportunity to make oral or written submissions Inmate advised of opportunity for Interview with Superintendent - Inmate waives ior Interview with Superintendent Name ofSuperintendenUDesignaIe (Print) . I Signature otSuperint ndentiDesignate . Date S.McWhinnie - 3 04/25/2014 A . - - .. Superintendent Decision (This section must Ire-completed within 5 days of the inmate's placement in segregation} InmaIeSumesaion ,1 I I . States he had some problems on the unit, Superintendent Decision El Release from Segregation ?14 Continue Segregation Reasons: I . . Subject was on beth PC Units on several different rangess but was untlmately run off ranges. by other inmates because of his behaviour. Name of SuperintendenUDeslgnale (Print) Signature of Superintendent/Designate Date s. McWhinnie . 04/30/2514 Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submisslon - gaLLQJ?Qcioo??pmkl?L/o (3m ELLA 7% . ?will lama/L9 - Wei Ot/r: Moi g?on? Mix/9 now Superintendent Decision El Release from Se?ralion Contlnue Segregation Ream?: Came ALA ban mm pro . LOJLO 9601 opgam if? Name at SuperintendanUDesignate (Print) Signature of SuperlnlendentiDeslg-nate Date I 5/6/14 .SUppIementary Repert for each Subsequent 30 Day Period {use reversia orrorm ioradditionaioomments} . . Comments Superintendent/Deslgnate Signature Date 030 075?100 (10104) stN/R s.21(1) 000243 - Page2 Regional Director Review Conlinueo Segr?e?galion Sypoded Not Supported Comments - . Name of Regional DireclorlDesignale (Prim) Signalure of Regional Director/Deslgnale Dale Sopplemeotary Report for each Subsequent 30 Day. Period (use bottom of form Wm! comments I 1 {go'srup? 801nth-b??ubmi?aslm . I - Slab/M?- ?010- (?02.1 "hJ G. Wu} d?g?-LH I I Continuod/Addilional Comments by SUperlntendenUDesmnale Commonls Signature Dale . 1[OMM5M/ro?cq?m 4k I . I PC- u/nd br?L/rww +0 (Qt/Wagi- warw 6/ I MP . ?40's .Tgremm'mqim Mfrokof?uhw 6/20/l4 b-ehcwaoLuL Macon, (an {1,139 .. i I erb?kfaumjs Eiffegmh Um En Gum otim. We LL Wi?s?m?c?mw?i? mam 35.ELVW I . .- 252is 'merokcaccjw' - 8m 5/30/14 f? I i owl/0412+ Continued/Additional Comments by Regional Director/Designat (D Commanls Slgnalum: Dale - ?s.21 (1) DI-IrlbuIlon: Original Regional Bic-actor {My In! Ramona! chor?uwbw) Copy - lrvnale Pia cso 000244 Page?z' 3 ?egionet Director Review Continued Segregation Cl Supported . CI Not Supported . Comment: Name of Regional DireetorlDesignate (Print) . I Signature 01 Regional DirectorIDosignale - Date SUpplementery Reportfor each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date . . MMIddImy Vm eannN-?a "To U-p ?gravk numevow? (3.10445 59-. "to Yemen.) 7 7 - ?es. To famed-r5 20% I Continued/Additional Comments by SuperintendentlDesignate . - Comments i Signature Date - - - A Vi - - - . ?(Mb - aware/1+ ?davu-lovv?a 'Iq - towa I I . we- LA. ?in 4&5 'Im vr?qws?l' . . 01"] lat/)4 MM W.) - meg-tom mind - Continued/Additional.Comments by Regional Director/Designate - . - Comments .. Signature Date A Dlst?nuiton: 0mm: - Regional Dlrector (om; forRegbnal Dr'de Review) . Copy - Inmate File (:30 075-100 (10r04) slN/R' 000245 9 Centr?l East Correctional Centre Inmate for 30 Day Segregation Revlews I Inmate Name: OTIS Number: lnmatq written for 30 day isegregatlon review: - 9 I 5Q, Lo W?w' minorx A Inmate Oral for 30 day segregation review: 7 (To be completed'by Segregation Manager) l- A. v. Inmate slgnature: I .Wltness Name: S-rot?e?tg 14g.? 2 I Date: . 9W s.21.(1) 000246 - ?R'egional Director Review Conlinued Segregation Suppoded Not Supported Commenls . . Page 2 Name 0! Regional DIreclorIDesignale Signature of Regional DIreclor/Designal? Dale Su?pplement?ry Reps?! for each Subsequent 30 Day Period (use bottom of form for additional comments Commanla Slg?nalure Dale 9 Contin'uediAddillonal Comments by SuperlntendenUDesignate . Comments Signature . Date . - Um- .aaw-J-mm 4n lac/Lava. unw$uMC0:1 41?? 4/ I i I 06/391 "(trim-4H- ?Ma 11: 1 I Wawdm3T. 4 w?ng 07/ ?5?{mo 75' 41m [a 1:191!? I MM LE: . Mum! mm; '7 Continued/Additional Uomme?nls by ?eglonal Director/Designate Commenls Slgnalure: Dale a i i 'i . Dl?rlbullon: (Mum-Regional Dirodor (OnlyfarReghIWGa-daRome Copy - Inman Filo . . l' CSD 075-100(10Io4) 521(1) 000247 Bentrel EaeECorrectlonel Centre Inmate Submission for 30 Day Segregation Reviews inmate Name: Number: Inmate written submission for 30 day segregation review: inrnate Oral Submission far 30 day segregation review: I (To be completed by Segregation Manager) Inmate signature-?1 . Date: -Julv19.2014 Witness Name: Sheena McWhinnE Witness Signature: 7 a shUR 521(1) 000248 why d? Regional Director Review Page 2 Continued Segregation Supported [3 Mel Supponed . Commenls Signature of Regional DireclorIDesignale Name ol Regional Director/Doslgnale (Prinlj' Dale Sopplementary Report for each Subsequent 30 Day Period (use bottom of form foradditional comments 1 Comments ll re? Dale qb . Mde/my {,Aase - $1415 W-W SIgna f! ?3 ?i Continued/Additional Comments by SUperintendenUDesignale Comments Signalure0331.0? berm mmr?ma 13:0 hie/I"! bun/(35 "r?o - Sua?tfa. A 11 I wruMWm-ucuw - 7?10"! 1% .L?o'f?O?fb Mac-'3'? Lax .WQ 'f?cmin - Mnj?ov?m up; 21% In . (2 Continued/Additional Comments by Rggional [)ireclorIDesignate i- Slgnalure: DaIa uwi'k'. $3 f0 Val?4": 0 fog-cot 004;. 7.91 Copy - lnrnale Fiie C5D 07.5-100 (10/04) i 1 Dislribullnn: Origin? - Regional Dlroolor (Only EDI Regional Difch Ravbw) - i i 000249 \to th MK. R?eg' ionai Director Revi'ew Page 2 Contlnued Segregalton SUpportod - - Not Supported Commenlt?u Name of Regional DIraclorlDest'gnale (Print) Data Slgnalure of Regional DlreotorIDesignate Supplementary Report for each Subsequent 30 Day Period (use bottom of form-16.3 1507737 comment's -, - Comments Sig . Date (573) A . W7 m} . Mag/J?; Ant/ma loucl . . out-Hm ocean upachrmqr". JLQ K, HM) H3 ContinUed/Additional Comments by SUperIntendentlDesignate . Commanls Signature Date Vm MEL ?xi-"Pom . Mgr-m m?fL- Wad?Lei WWA . ,l I o?t /osf/rf(~ . .- LAM-L 09/10/14? 'vw - Shoo mwm??c - kg, Continued! dditlonal c: ents by Regional Director/Designat?) Commenta' I Signature Date - - Mmenwy VM *0 Qua-icky G. ?6er . Loe?hxrgok Vi?ukgw? MP) I. Dlalriburlon: (nighal - Realms Dircdor (Only rorRegtonaI D'mdor Review) Copy - inmate File cs0 075-100 (10/04)- stN/R -sAzu2xd) 5121(1) :12t(2Nf) '000250 . DistriciAdmjnisirator Review - Page 2 Conlinued Segregation? Supported I Nol Supported Commenls 60 b? . r- Ithaca L-IUINCD Unu- Name of Disitld (Print) Geanf ?nger-J Signature OI Dislrici AdministralorlDasignale ?27360. Dale Hf each Subsequent 30 Day Period betlon'i of form for additional comments 1 SUpplernenlary Report for Commenls .95 Slgnaiure I . . Dale 60 '76 remch ?Au/Lea no 5L0 rac? ?6 I mitten i/ may/4* Continued/Additional Comments by Superintendent/Designate Comments Slgnalure Date - ?35 ?b??mgwg \ro Mm\n Am K) \ro :Nu Mua? [p/Olg/l-w ?63 - lD-jll?llke - - I +5 th? loll I l\ A wzx. 5 a N0 /o ?remmwm :3 2 Continued/Additional Comments by District AdministratorlDesi naie C0mmepla Signalure Dale c?sp Dial?bullon: ongou - Dishid s.21(1) Adminlalrdor (Only (or District Adm'nislrafar Review} Copy - Inmaio File 000251 Central East Correctional Centre . Inmate Submission for 30 Day Segre?getlon Reviews inmate Name: OTIS Number; inmate written submission for 30 day segregation review: InmateOrai Submission for 30 day segregation review- (Tobe completed by Segregation Manager) I i r, s.21(1) - . i . .inmete signature: . . Date: October 25. 2014 Witness Name: S. McWhinnie - 0" Witness Signature: 3% 000252 PF) Segregation Decision/Review I and lanai)? ?eim? I ano (termite)? - Lit-1U ~43; -. /_,instiuion- . fewer? . .1 "Central East Correctional Centre Client identi?cation No. I Name (Last, First. Middle) Raason(3) for Segregation Mr? ?Dale ofSegregalion- Protective Custody Institution Security Medical Inmate Request ?bu?M 7 23' sep? 14 Inmate advised of reason for segregation I a Inmate advised of opponuntly to make oral orlwrillen submissions Inmate advised of opportunity for interview with'Superiniendent inmate waives opportunity I Niew with Superintendent I . Name of SuperintendenUDesignale (Print) . - - Signature of SUperi I Date Staffers 25 Sept 14 Superintendent Decision (This seotion must be completed within 5 days of the inmate's placement In segregation) Inmate Submission .1 - - . IIM returned after 16 days at an oUtslde assessment (PCMH) Scar-v 4' t9 3 - . 5X33 sf?: Q'w Incl-vaopv" and. \ocaLGV. Superintendent Decision . Retease from Sgg?agalion iZi Continue Segregation Reasons: 6&0"qu ?YC?Sevu?d 11-0 P?bqqub5% Name ot-SuperintendenllDestgnale (Print) Signature of dent/Designate, Dale cam: oq/zq/I?L? segregation ?0 be reviewed every days. interview with inmate to be conducted every-30 days) Inmate Submission 'Vh?t +5 aom?ixa SUperintendentDecisiOn Releasetrom Segregation . Continue Segregatlon Reasons: cruw/ Name at SuperintendentlDeslgnala Signature of Walgnaie - Dale . gpmt' rule's/1+ . I I Supplementaryjeport for each Subsequent 30 Day Period (use reverse arrorm {or additionarcommanrs?) . Comments Superintendenuoesignale Slgnalum Dale CSD 075?100 (10104) I S.NIR s.21(1) 000253 7 . 7? (If? I?m ?mkwa LO [MppVogTA/latu to] Regional Director Review Page 2 Conllnued Segregation Suppon?d El 00mmenle gobu_ A5 B?H??utu?u?. Q15. Not Supported HMIHC- (356.: tam ?uc?Mms?rl?wem?m?' Name at Reglonal DirectorIDeslgnale (Print) Signature oi Regional DirectorlDesignale ?763 a? Dale li/U? Zg?f Supplementary Report for each Subsequent 30 Day Period (useiao?om of form for additional comments Comments Slgnalure Dale We'll) I ?Giaww'aha-M I randa/?ptwi Ale Jrnmarbm?x 017/29! rm u. by Superintendent/Designate comments Slgnalure a . Dale NIdeer A mhf?j . 75 2' Q/sz ?jm :Ah- Ma ?L?Im?v 7 lit-?M? f0 $51 in . '36' - - . Continued/Additional Comments by Reglonal Director/Designate Cammenls - .Slgnalure Date - original Regional Dlredor {My [or Regional DiredorRavlan Copy - Inmate Fila cs0 075-100 (10/04) 521(1) 000254 Cantrell Eaet Correctional Centre ?nmate Submlaslon for 30 Day Segregtlon Revlewa lnmate?Name: OTIS Number: Inmate written for 30 day segregatlon review: Inmate Oral Submission forvao day segregatlon revlew: (To be completed by Segregation Manager) 521(1) Inmate slgnature: Witness Name:_ 8. Witness Signature: Vt! Date: October 26. 2014 000255 2r?" I 52?? Segregation Decision/Review an Orrec Iona . - (Ontario twee-io-wumi' - Institution f, . I .1 'ani . Central East Correctional Centre x. 233.91: .- Name (Last. First. Middle) Li Ghent Identification No. _Reason(s) for Segregation ?Date or Segregation Protective Custody Institution Security Medical Inmate Request 27 sap! 14 Inmate advised of reason for segregation Inmate advised oi opportunity to make oral or written submissions Inmate advised ot opportuntty Ior Interview with Inmate waives opportunin for rvtew with Superintendent Name or Superintendent/Designate (Print) Signature of Superinte tale Date Sgt. K. Stoffers . I 29 Sept 14 bu, Superintendent Decision (This section must be completed within 5 days of the inmate's Meow-segregation) Inmate Submission . i/M admitted on suicide watch I IIM displays unueual and bizarre behaviour - reIerred to has been in and out for past few months? Superintendent Deotslon El Release from Segregation Continue Segregation easons i ?lbw .H. mac ,n o-L I Name ot Superintendent/Designate (Print) mt LO I Signature oiSuperintendent/Designate . Date . . i W. (go-M. Mob/(f . Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission i Superintendent Decision Release from Segegalion . El Continue Segregation I Reaso A i - n_s . +0 began/i1 av} 6L rl-D int-chaotosux Name or Soperintendent/Designate (Print) . Signature oI Superintendent/Designate - Dale it? . . 10-07 Supplementary Report for each Subsequent 30 Day Period (use reverse arronn [or additionatcomments) Comments . SuperlntendenUDeslgnate Signatt?rre Date 630 075-100 (10/04) - s.21(1) 000256 Regional DirectOr Review Continued Segregation . Supponed Not Supported 7 Page 2 Comments 3 1:1 I Pee mrm??c? Summatqu name?: Sam?s-g ?l Name of Regional Director/Designate (Print) GEOCF Signalure of Regional DirectorlDeslgnala Date 11/06/1013? Sugglementary Report for each SUbsequent 30 Day Period (Use bottom of form for additional comments Comments Signature I Dole unable. 6/1) Mon! Jan 6% A2. #1ch th?lm ?30 Muck-Iv lac, bw Ace. ?brmr? Lm . Continued/Additional Comments by Superintendent/Designate Comments Slgnaluro Dale . . Utmu-? v.AiliM'. - Lq/ Um orxoewmi?x? - 16/19/14- 0.3 Amti' i um. Mom on a, JAM. t1? 6 3'5 ?f . Ber/0.224% to mus-Joh- lu luux an?? Mala?k. A 7 ll . aw P??bkokhgk?t 70.237.1'44 '73 ?maom cw Witt-n M?w ML . Continued/Additional Comments by Regional Director/Designate Comments Signature Date Copy - Innate Filo CSD 075-100 (10104) Distribution: 009M - Rnaimel Dilute! (Only for Regional auda- Review) 000257 Central East Correctional Centre inmate Submission for 30 my Segregation Reviews inmate Nair-ne: OTIS Number: .- llnmate written submission for 30 day segregation review: inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) inmate signature: Date: October 27. 2014 WitnessName: A Witness Signaturezs 6 000258 .. ?ti?s Safety . . and Correctional Services Ontario Segregation Decision/Review i ,instituli?n Central East Correctional entre . a mum" -- Name (Last. First. Middle) Client Identi?cation No. I Heasonisj ior Segregation Date of Segregation 26 Aug 14 Protective Custody CI institution Security Medical inmate-Request Inmate advised oi opportunity to make oral or Written submissions Inmate advised oi reason ior segregation Inmate advised of opportuniiy [or interview with Superintendent Inmate waives opportunity ior interview with Superintendent Name at SupBrintendeniiDesignate (Print) Sgt. K. Sioifers Signature oi Superintendent/Designate i Date 01 Sept 14 Superintendent Decision (This section mustbe completed within 5 days of the inmate?s placement in segregation) . inmate Submission . IIM admitted from TEDC - requested segregation - claims he will kill someone if placed one regular living unit Ci Superintendent Decision, Release irom Segregation Reasons: E4 Continue Segregation Name of superintendent/Designate (Print) Signature oiSu r' nd UDeslg ale i o?i/c: Date Segregation Review (inmate's segregeiiOn to be reviewed every 5 days. interview with inmate to be conducted every 30 days) in'rnale Submission Superintendent Decision -i:i Segregation Ci Reasons: ContinUe Segregation hm I Name of Superintendent/Designate (Print) Signature of Superint?we Dale 09/6 row/27? I I Supplementary Report for each Subsequent 30 Day Period (use reverse of form for Comments Superintendent/Designate Signature" Dale 5 050 075-100 (10104) S.NIR - 5.21 (1 - 000259 - Page 2 Regional Director Review Continued Segregation El Supponed Not Supported Comments 5 1 Name of Regional DirectorIDesignate (Print) Signature of Regional DirectorIDesignale Date I Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments 0?4 A?l/jl 0/97 ContinUed/Additional Comments by SuperintendenUDesignate Comments . Signature; Date 5- . mm? . W) ?~31 .Ae?tngSa?ci' - fits?g; . we i?h?=?dg sag . Continued! dilional Comments by Regional DirectoBtDesignate - . . Comments Signature I Date 5 5m vw ebb-3&1. - . I . Dislribullon: Origlnal - Regloml Director (Only Iorngbaaf D'redar Review) . Copy - Irmaie Filo . 030 075-100 (10/04) 521?) 5021(2xn 000260 I Central East Correctional Centre 7 I a inmate Submission for 30 Day Segreetion Reviews '1 inmate Name: OTIS Number: inmate written submission for 30 day segregation review: . . . r. - s.NlR inrnate Oral Submission for 30 day segregation review: 14(2)(d) i (To be completed by Segregation Managerot?nulo oI-law/?1 (1151/) ?l'kffrukMM Inmate signature: Date: 00+ i/H Witnese Name: i ?yw- 25w an. I Witnese' Signature: Qeezek @d-El'q 0. i 000261 Page 2 District Administrator Review Continued somegation Supported Not Sapported Comments Cyan? Heme? SuBmiiSArcu-J Name at District AdministratorlDesignals (Printj' Signature 0! District Administrator/Designate Data Gm ?nned-?C ?aq?L 06/20/51, . . I I S?pptementary Report for each Subsequent 30 Day Period (use bottom of form for additionai comment's Comments Signature Date 19 thmafta JUL +0 60 (4,0 09.01 5/ I (l Continued/Additional Comments by SUperintendenUDesignate Comments i Signature - Data Inmaie mam . I ?Vol/(HIM?trim Hm 499. 7 .- 5 64-. damnang ul awh? . :0 .M (90 106/} [Ir/h - /0 Co?t?ftinUed/Additional Comments by District Administrator/Desi nate . Comments 7 - Signature Date chlributlon: Original - Distrid Administrator (Duty {or Distmi Administrator Review) . Capy- Inman File - cso 075?100 (10104) 521(1)- 000262 Central East Correctional Centre inmate Submission for 30 Day Segregation Reviewa inmate Name:_ OTIS NUmber: Inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: . 521(1) (To be completed by Segregation Manager) - i I I I Inmate signature: Date: October 26, 2014 Witness Name: 3. McWhinni'a? Witness Signature: 000263 i . -M n strv of Community Safety Segregation Decision/Review I - and Correctional Seririces - _n arm .0 merge-ennui - lneiittilion F141th i3 I kp?QtD i (Central East Correctional Centre- Name (Last, First, Middle)? Client Identi?cation No. ?1 Reason(s) tor Segregation - Date of Segregation El Protective custody institution Security Medical Inmate Request . 29 Sept 14 EA Inmatetadvised of reason tor segregation Inmate advised of opportunity to make oral or written submissions inmate advised of opportuntiy for Interview with Superintendent Inmate waives opportunity town with Superintendent Name - Signature of Superintend nate Date Sgt. K. Stoffers 30 Sept 14 Superintendent Decision (This section must be completed within 5 days of the Inmate?s pleoement in segreoatlon) inmate Submission IIM admitted from Quinte refuses to go to a Unit - tears for his saier Superintendent Decision Release from Segregation Continue Segregation Reasonsz?vfw: 10 i. Name ofSuperintendent/Designate (Print) Signature otS er' den esignate Date Sro?'?m . Cami Se re ation Review (Inmate's segregation to be reviewed every 5 days. Interview with Inmate (a be conducted every 30 days) inmate Submission . . i i Superintendent Decision - Release from Continue Segregation Reasons: Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date tat/??Tac?m ?ow-II IDIF'Bjii?ir' Supplementary Report for each Subsequent 30 Day Period (use mVerse arrorm roradditionaleommenrs) Comments - .7 Suprintendent/Designate Signature I Dale' - CSD 075-100 (10/04) 514(2)(d) 1 521(1) mm - 5-21i2iif) 000264 Regional DirectOr Review Page 2_ Not Supported Continued Segregation Supported Comments 330% {EgerE5T Gad. Name of Regional DirectorIDeslgnale (Print) I Signature of Reglonal DlreclorlDeaignale Dale GW-bau??u( ll/d/ulq Supplemenlary Report for each Subsequent 30 Day Period (use bottom of form for additional comments 7 Commenls Signalme Dale A - . 30 act?41042;? ,cmim Em" 29- ?74 LA?u/??ar1axwy ob?? . I Continued/Additional Comments by Superintendent/Designate . . CmnmeMs 'SmnmUm Dam 5K3 stL?Y\?kZiW ?zfs.Q-i apoConlinuedlAddilional Comments by Regional DIrector/Designate .7 -Sbnmum Dme Dlnl?bullon: Ociain-?J - Regime! [?reuor (Only for Cow - Inmate Filo cso o75~1010(10104) 521(1) .000265 2W1 'lnmete Submteelon for 30 Day Segregation Reviews Central East Correctlonal Centre Inmate Name:_ . I OTIS Number: l?nmate written submiselon for 30 day segregatlon review: Inmate Oral Submission for 30 day segregatlon review: (To be completed by Segregation Manager) 521(1) Inmate sinature October 29. 2014 Date: Wltnees Name: S. Wltness Signature: 000266 Ministry of Community Safety and Correctional Services y. QC Segregation Decision/Review i a . . . =7 Central EastCorrectional Centre 5.4 Name (Last, First, Middle) Clith identi?cation No. Reason(9) [or Segregation Dale of Segregation 27 Sept 14 '8 Protective Custody El Institution Security Medical inmate Request Inmate advised of reason for segregation Inmate advised of opportuntiy tor Interview with Superlntendent Inmate advised of opportunity to make oral or written submisslons Narneoi Superintendenuoeslgnate (Print) Sgt. K. Stol?lers Inmate waives opportunity lorlntervlew With Superintendent Date Signature of Supelee - Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) 29 Sept 14 Inmate Submission . IIM involved in altercation on 6 pod Lo ram-b. pen-Ax- Superintendent Decision Release from Segregation 33 Continue Segregalion Reasons: Subbed Ham ia_,rz_o_,n Mm bed-12?? WP 0? (oPocQ QS rune-k: Dm? broke l?c-Ah? axing. - B'Lmkac? {o/al/11.03%! I - \l . Raw/oifni,k_ caveat? er u?orn . (Lt/Lo, II. (Mb/ff Continued/Additional Comments by Regional Director/Designate - Comments Signature Date 21(1) A I Dlalrtbu llon: Original - Regional Director for Regional Dm?Dchyiaw) 030 075-100 (10104) Copy - Inmate Filo . 000282 Central East Correctional centre lnmateSubmission for 30-Day Seregatlon Reviews Inmate Name:_ OTIS Number: 'lnmate written submission for 30 day segregation review: I Inmate Oral Submiesion for 30 day segregation review: -. (Te be completed by Segregation Manager) i I inmate signature: Date: November 642014 WltnessNamer S.McWhinnle A Witness Signaturer Lig?gs?L? 521(1) 000283 'L/ld . . Segregation Decision/Review mag-?lo -I Ll: - Institution/?V if; Central East Correctional Cen_tr ontario Ministry of Community Safety and Correctional services Name (Last. First. Middle) Client Ide'?ti?cation?NW? I Date of Segregation Protective Custody El Institution Security Medical' Inmate Request i 04 Jun 14 Reasonts) for Segregation Inmate advised of reason for segregation Inmate advised of opportunity to make oral or 'written submissions Inmate advised of opportuntiy for interview with Suoerintendent Inmate waives opportunit?or interview with Superintendent Name of Superintendenthesignate (Print) Signature of esignate Date K. Stoffers. COM1 05 Jun 2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission . - Admitted to segregation from 4A (tried GP then PC) Bizarre behaviour - unable to function on unit at this time Superintendent Decision El Release from Segregation 52 Continue Segregation Reasons: - l/rb Name of Superintendent/Designate (Print) - Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every .30 days) Inmate Submission (Rama's 1? Continue Segregation Superintendent Decision Release from Segregation - Reasons: Name of Superintendent/Designate (Print) Signature of Superin UDeeignate Date' 56ft. Supplementary Report for each Subsequent 30 Day Period (use reverse ofform for additioneilcornmentsi Comments Superintendent/Designate Signature Date smUR - - i 1Al'1\ sa21u) iguana 09 C5D 075-100 (1 0/04) if; as 000234 Signature mum?gnate . Date Regional DirectorReview Continued Seggegation Comments Supponed Not Supported Pageg Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Sugplementary Report for each Subsequent 30 Day Period (use battom of?form for additional comments - I Comments mum, MM/Z?fiyvy Axe-tumflu-SS ., i Continued/Additional Comments by Superintendent/Designate Comments Signature Date 1 15 Lu My: I bb/Iq/lq 9-0 dmm' 4m ?Ki/3 Jam-?ll, vumy 5' 41> MM ?Ru . I MWOW -meJ?gba 1 pg- ?Jn a Luna-:1 442-?) HH-LW oG/aq/qu' 9 11: ,0-3 Vex/xylem, . wag/?t - (/1436? . EL I . Continued/Additional Comments by R'?giorf'ai DKv?ctorlDesignat Comments . Signature Date - i . i . i ?s.21(1) 91 v.5 cso 075100 (10/04) Dlatrlbutlon: Original - Regional Director (Onry for Regional Director Review) Copy - Inmate File 000285 'Ct?O'laL. cehu?l Eaat Correctional Centre Inmate Submission for 30 Day Segregation Reviews Inmate Name: ?7 OTIS Number: Inmate written submission for 30 day segregation review: . I 521(1) Inmate-Oral Submission for 30 day segregation review: . (To be. completed by Segregation Manager) 1 Jnmate signature: Date: July 2014' Witness Name: Sheena Mch-innie . I - - 1 Witness Signature: I . 7 i 000286. Regional Director Review 7 Page 2' Continued Segregation Cl Supponed Comments 7 Ci Not Supported Name of Regional Director/Designate (Print) Signature of Regional Date Supplementary Report for each Subsequent 30 Day Period (use bottonmr mane: comments} Comments A Date - it?) WHL .A'Xd?b? st'Sr (xv-z regain?'5 000M I/Ean?Sf 37/ 3/175 Continued/Additional Comments by Superintendent/Designate . - Comments . Date Wmer?) Wm? trim/um MM - a - 7/2904 . mmouto ngiuakmr-l-o fir/3W4 57'? Yawtd limb. or bi Continued/Additional Comments by Regional Director/Designate Comments Signature. Date I I semi Distribution: - Regional Director (Only for Regional Director Review} Copy - Inmate File cs'o 075-100 (10104) 000287 Page 2 Regional Director Re?iew Continued Segregation Supported . 7 Not Supported Comments I - Name of Regional birectorlDesignate (Print) Signature ef Regional Director/Designate Date . i Supplementary Report for each Subsequent 30 Day Period (use bottom ef?form ditional comments) . Comments lure Date my - d? it - ogidazc?oppm you. Low: L- Mornch moictzofrng. 0. AW LOOKW boa/n+3sz Continued/Additional Comments by Superintendent/Designate? . - . . Comments Signature 7 Date A *1 5ft: ?5 mm? . Mailmdx gaurmqucngu? . . @mvx?w - 08) --1 . \Quts *?m?da?il?mwg?m . a 0 Wh- egg/rm w: . ?l 8/ 1% Continued/Additional Cou?l?lme?tsgy Regional Director/Designate - .Comments Signalure' Dale - sewibk- S.NIR _s.21(1) 511(40) Dlsulbutlon: Original - Regional Dlraclnr (Only for Regional Director Rattle-m) Copy Inmate File 030 075400 (10104) 000288 . Central East Correctional Centre Inmate Submission for 30 Day?Segregation Reviews Inmate Name: OTIS Number: Inmate written submission for 30 day' segregation review: . Inmate Oral Submission for 30 day segregation review: 21(1) (To be completed by Segregation Manager) . Inmate signature: Date: Auqust312014 Witness Name: Sheena McWhinnie Witness Signaturez?rw/ - 6 000289 on Continued/Addilional Co?m?its by Regional Director/Designate Regional Director Review Continued Segrggalion Supgorled Page 2 LJ Nol Supported ECfamnnen?ts 9C) 2? m- sew. Mme ME 0281 (a IN Name of Regional Diredormesignalo (Print) 49% @?wc Signalure of Regional Oireclorlooslgnala Dale 07/15/201? SUpplemen?y Rapol'l for each Subseguenl 30 Day Perlod (use bottom of form ditional comments Comments (an) +13 Mama-Ca Lou?tum: A . glam 11m Magat?ofgmz. . Ora? - 0? I Comm?nls by Supe?ntendentIDesignale . Commanls - . Signalman Dale MdeImyr \lmv _g ??hmxotaw -. OBI 'O?M-?Quobn u-?hw?kc-QaJW. I?Plu 25.x. - 7 . 51/2/1114 humans. ?3 m'ww m-me' - Commonls 8 i9 nalure' Dale s.21(1) Original - Rumba! (Only Copy - [nmala ila 075?100(10104) 000290 Page :2 Regional Director Review - Continued Segregation Supported - Not Supported Comments . . . . - i Name of Regional Director/Designate (Print) Signature of Regional Direct arlDeSignaie Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for?addittional oomments . Comments i Signature Date 30;; a CL?C/Cbnmi MA. 405mm um - 0W4 SMM Lowell/w .po MW 442M w: /q fig/L, I 4977 i Centinued/Additional Comments by Superintendent/Designate 7 Comments Signature-1 A '03 2% LO Te?x?eheakebxk. w' . [6 line AME/wag 13 LyeWe,? ?3.0.1.14 t3: (Wt/mm; Miami/90$? axe?QMm-?Sgth - I '3le Lo M440pr - 7 /0 '07. ftf? r0 {m '1 tag "Wm ?ewe-9% #27' cave Continued/Additional Comments by Regional Director/Designate I commean - Signature? - Dale 13b Inmate ?f 7L0 MW . I 7. 5724(1) Distribution: Original - Regional Director (Only for Regional Director Review) Copy - Inmate File cso 075-100 (10}04) 000291 Regional Director Review Page 2 Continued S_egr_egation Supported [j Not Supported Comments Mat-{L 2K amakm I 4/ Name of Regional DirectorlDeSignate(Print) Signature of Regional Director/Designate Date I. get/?: gmzq?'x ?mra. 0t ll/lo/ZOIQ? . - Supplementary Repon?. for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments Signature Date A Continued/Additional Comments by Superintendent/Designate Comments Signature Date urinate - +31. . 5 are mm 7?40 \b 1N id's VM ?tgliimwx. CLQAO If. ?mac-pow paHtQ? . Continued/Additional Comments by Rigignal Director/Designate Comments Signature ?Date . . MM/dd/yyw s.4i(i) Di atributjon: Original - Regional Director {Only for Regions! Director Review) Copy- Inmate File CSD 075-100 (10/04) 000292 i We? 0f 90mmunit? Safety ?3 Segregation Decision/Review - and Correctional Serwces - . Ontario - :3 ?entral East Correctional Centre Name (Last. Firel,'Middle) Cid: It'?QaUgQ?u?oM fit" ?Reeaon(s) for Segregation Date of Segregation - Protective Custody Institution Security Ci Medical inmate Request - 07 Aug 14 . Inmate advised of reason for segregation Inmate advised ofopporlun'ily to make oral or Written submissions i Inmate advised of opponuntiy for interview with Superintendent inmate waives opportunity ior interview with Superintendent Name of Superintendenuneeignate (Print) Signature of Superintend eetgn te Date Sgt. K. Stoffere - - . 3 08 Aug 14 Superintendent DeCISlon (This section must be completed Within 5 days of the Inmate's placement segregation) Inmate Submission . Unalble to function on any units - admitted from 60 Can be erratic and volatile - \fhn W. Superintendent Decision Release from Segregation K4 Continue Segregation Reasons: -\3?\wviaw\/ i5 Stiller-Shin.? ?nguteox . . I I Name of SuperintendenUDesignale (Print) Signature of Super? tie De ignate Dale o3 )31/ r' arr: c9657:- - I Segregation Review ?nmete?s segregation to be reviewed every 5 days. Interview with inmate to be conducted War}! 30 days) Inmate Submission i 59*} As -iSuperintendent Decision" - Ci Release from segregation - Conillnue Segregation . Reasons: Mt (Q [a . veg/n. - .mm?t gait/13.4101 . We Name of Superintendent/Designate (Print) Signature ofSuperintendenUDeelgnate Date . - Supplementary Report for each Subsequent 30 Day Period (use reverse oftorm for additionaiicommenrs) Comments - SuperlntendenllDeslgnate Stgnature Date . I 3 i 5.21 (1 CSD 075?100 (10/04) 000293 65 5? 4i .. Regional Director Review i Page 2 El Continued Segregation Supported .N'ol Supported Comments Name of Regional DirectorIDesignate (Print) Signature oi Regional DirectorlDeslgnale Date Suggiementary Report for each Subsequent 30 Day Period (use bottom of form for?ddi'tional comments Dale Comments - i . prom-ch.0 n1.qu a. cf?. OWELQ Autonxi-ssm W41 ?13 I i? Continued/Additional Comments by Superintendent/Designate Signature LAWWg-nhg? Cm Comments Date I . vodka-4% . unpradJe-?t-mm I Jukebdiouuv - uw?a W?alhk4 90-? 6L ?wk?l: . .1 03(12qu inmafu. 4; 1 4n. anti-PI; 3129/]? o9/orl/l?f I I I - 1 W00: GILOL 9F)ch "Pu/ma 41/] (Lam. . Mx- rva/Ar-UW OQLC, MCI0.91/5) rm TD 1-D QM by.ka v.2 . 1 Mug/fan-M4 +0 4 1?m\1\5\ you? 05? wx $3 Emme in.? V0 0.4 WA oql?b/lq? Continued/Additional Comments by Regional Director/De?signate i i Comments . Signature: Date . i . - 3 5.21m . . I Original - Regioan DirectorfOnnI forRegIonai Director Review) Copy inn-tau: Filo CSD 075-100 (10/04) 000294 z! 35 Page 2 Re'gkmal Director Review ConU??ed Segrega?on E- - Supported Not Supportgd commanls_ Q?s-mm A1 '330 tan-t . Cam iu?md?mu? lb QEfan ILJ Name of Reglonal Dl?reclorlDaalgnale (Pu-Ink) Shhalure of Regional Dlred'Pr/Designale Dale 42w mex 0 7/ 5 Supglemenlary Riporl for each SubseqUent 30 Day Period {Use bollom offerm fOf?ddj?onal comments - Commenla Sla Dale 0 - - A, . Mdelmm pro n1.qu (L, With?!? 1 N, waster? i r?mam . I I I Continued/Additional Comments by SuperlnlendepUDeeignale Comm'enls Slgnaium Dale HIM/dam?? Hay-.5 vwkmU-a? we! we, 5 bawdamv 9w 6.. mw?a?k I a-e? "It ?ag- LJ . I 3123/4} \b Til -. pro Au, WW1 ~31. . I I CL.qu rug-rer TD GLAJ- . . - 1 W91 57/5711ContinuedIAddilional Comments by Regional Director/Designale Commants . Slgnaluro; I . Dale r_ . s.21(1) I organ-ah Raw Direcw (Gab-11553153 b?mdvRu riot-a I copy- Inmate F09 can 015-100 (10/04) - i 000295 Continued Segregation Regional'Dlreetor Review I Supponed Not SUpported Page 2 Comments Slgnalule of Reglonal DlreclorlDestgnale 'Namevof Regional Director/Designate (Print) Date Supplementary Report for each Subsequent 30 Day PeriOd (use bottom of fp?raddi?pnal comments . Comments II?SlgnaW Date Jag) I /a/c136/zomung m?me-sum alumin? Mo mull??0' ?lo-{3 I . lF continued/Additional Comments by Superintendent/Designate I Comments Signature \f Len-J?th It {x ave-.66; \b?kau'l QM - 34?55Gallic/I?l- ?Jm A'b Cow-Pol: ?3 amw?m a 091/ 25?ng My Vm waking hadn?t? modmlcatur nucoL o"I/Bo/Icl [new 4pc) ?m \Qm. \Im 123$ mi?n-?r? 1:9 Himalaqu lo/Ofll'f Continued/Mitional Comments by Regional Director/Designate I Comments - Signature Date - 1M 2 a n- MAM 1Al9\lr~l\ s.21(1) I Dlulrlbullon: Otiginal - Regional Direclor (Oniy for Regional attractor Rew?aw) Copy - Inmate-?le CSD 075-100 (10104) 000296 Centrei East Correctional Centre Inmate Submission for 30 Day Segregation Reviews inmate Name:_ OTIS Number: Inmate written submission for 30 day segregation review: Op": :3 - . - Inmate Oral Submission for 30 day segregation review:- - .(To be completed by Segregation Manager) i - - I 5-21i2iif) Inmate signature: Date: Witness Name: I - 000297 Page 2 District Administrator Review Continued Segregation I Supported Ci Comments go JD - Law-1L Dubnukultr~( 363 I )ilu?u?-uh?ik Name of District AdministratorlDeslgnale (Print) Signature oi District AdministraIOr/Dasignale Dale ?ln?mr/ I . . . Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Not Supported Comments Signaiure . Dale . a MMiddiywy 'ScLbAng-r CL . @W?ng w?gq Lily/now Law kin/1:44:13 .. +0 thaw mango EC. - Wm- Omit (LL/[mop Continued/Additional Comments by Superintendent/Designate i Comments Signature Date Mde?myr . 0 toe/@1575 quSL 'P??cxbw . Intrme is; Mao/,4 ?w?lb/Hr 80 ainggii?ilkmS-dbaoki 3,214/1- ?a 9g ?ll-Carl" 90:0 WG-5 Lei?hi) (ANA, 2L0.ng bomb. 30..) 46 Wei 5W- C10 - H?bLf-Ici gentinued/Additionai. Comments by nate - . Comments Signature Date - S.NIR 5714(2)(d) s.21i1i i Distribution: Original - District Administraior (Only (or Disiricf Administrator Review) Copy - lnmale File CSD 075-100 (10/04) 000298 Central East Correctional Centre inmate Submission for 30 Day Segregation Reviews "inmate Name: OTIS Number:__ inmate written submission for 30 day segregation review: 521(1) Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager). - Submit/F "349% 4/5 mdria??i man/91,94 the, Liam.) lount id lF?EQ?b-i (41.6.3: iL/c wows/i. Jain; ?m seem-Lga??u 41) Page and chii'cfmfo GM Otm?bL/ camel; 0 . In . Deter Noyember AL 2014 inmate signature: Witness Name: McWhinnie Witness Signature: 000299 _v I I . Pym) I Ministry of 00mmunity Safety - Segregation Decision/Review 0 - and CorrectronalServicee - . 1 - arro .c?HQ?tgeto-iU4ei (Ansiitution I Central EastCorrectional Cen Name (Last. First. Middle) 1 \Wa?o: I _Reaeon(s) tor Segregation Date oi Segregation Protective Custody Institution Security Medlcal Inmate Request 30 39m 14 'Inrnaie advised oi reason (or segregation Inmate advised of opportunity to make oral or written submissions Inmate advised oi opportunity for Interview Superintendent Inmate waives opportunity [printout/aw with Superintendent Name of SuperintendenUDesignaie (Print) Signature of Superlntende ate Date K. Stofiers . 03 Oct 14 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement In segregation) inmate Submission admitted from MD on suicide watch . . ?th .t to out? I Lo . Superintendent Decision Release from Segregation K4 Continue Segregation Reasons: mjd?gpwawwt. Name of SuperintendenUDesignate (Print) Signature of Su erin Design?ale Data I #1 t?omt ?1 F4- Segregation REVIEW (Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) . Inmate Submission s.21(1) Superintendent Decision Release from Continue Segregation . .Reasons: . Name at Superintendent/Designate (Print) rgna re of rintendenUDesignate Dal I Supplementary Report for each Subsequent 30 Day Period (use form comments) Comments Superintendent/Designate Signature Date s; CSD 075-100 (10/04) 000300 8. p. Regional Director Review Page 2 Continued Segregation Supported Not Supported Mr Warez? Wri?w?? Name of Regional DirectorIDesignale (Print) Signature of Regional DlreclorlDesl nale Data be Amt (f Supplementary Report for each SubsequentSO Day Period (use bottom of form for additional comments Comments Slgnature Date .. +0 4:2 5704-3 Cg Mwmo?ahfsq Let/ta.- 7/ Continued/Additional Comments by Superintendent/Designate Comments Signature Date - Jm l. I - to. - MM. Io/Is)z+ I lot/qu 1+ Cwmg, loll-DIM} Regatta/bog ion/mad:? o;w Na .- [0,3044 {24' Lust?z forearvf?CCVL . .. . miter/o New. we 5312 A Continued/Additional Comments by Regional Director/Designate Comments . - Slgnalure Dale . s.NlR s.21(1) 7 Original R=gional Director (Only far Regional Director Review) - Copy-Innate File CSD 075-100 (10104) 000301 Central Eeet Correctional Gentre inmate Submission for 30 Day Segregation ReVlewe Inmate Name: Li OTIS Number: Inmate written submission for 30 day segregation review: inmate Oral Submission 'for 30 day segregation review: (To be completed by Segregation Manager) inmate signatd?rT 9: October 30.2014 (I - s.21(1) Witness Name: A I Witness Signature: 000302 g? I .- Wr Ministry Com'lnsunittl? Safety Segregation Decision/Review . . - and Correctlona an! cee . Ontario were-to - th I ?utter?N if/Centrai East Correcjio al ?entre Ct'Uv Clien?denti?ea?o?f/ Heasonis) tor Segregation - Dale of Segregation Name (Last. FirsL Middle) - 10/03/2014 Protective Custody Institution Security i:l Medical inmate Request inmate advised of reason for segregation Inmate advised of opportunity to make oral orwritlen submissions Inrnate advised of opportunity for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name ofSuperintendenUDesignate (Print) Si Suture of Superinten UDesignate Date s. McWhinnie - 10/03/2014 Superintendent Decision (This section must be completed within 5 days of the inn/site?s placement in segregation) inmate Submisslon . i . - vi Requesting to remain in segregation states he doesn?t get along anywhere else Swenntendent Decision Ci Release from Segregation Ki Continue Segregation Reasons: - Bizarre I unusual behaviour unable to function on a regular living unit - referred to I Name?oi SuperintendenUDesignale (Print) Signature of Superlnte tyrant/Designate Date S.McWhinnie - - .Stl/3?Lp mos/2014' I . Segregation Review (Inmate?s segregation to be reviewed every'S days. interview with inmate to be conducted every 30 days) Inmate Submission - - (Jr/\x Syen?ntendent Decision El Release from Segregation Continue Segregation Reasons: . . . . (Q 61/1 an Ck _/t.r2 UCLA Name ol Superintendent/Designate (Print) Signature of Superintend ttDesignale Date up - I . . Supplementary Report for each Subsequent 30 Day Period (use reverse ortonn for additional comments) Comments SuperlntendonUDesignate Signature - Date . - s.21(1) CSD 075-100 (10/04) 000303 Regional Director Review Page 2 Continued Segregation Supported El Not Supported (Somme-ms 30A 5? :?ujrg Ji" . Name of Regional Director/Designate (Print) 050?; ba?l Signature of Regional DirectorlDesignate Dale "/10 Lol?f Supplementary Report for each Subsequent 30 Day Period (use bottom of form {or additional comments Comments - Signature Date Bo - MMIdd/my .1241 CA Act?bawmi ac: . l? a 3] Cgop if, I 50:5- . zit-f: FD I ContinUedIAdditional Comments by Superintendent/Designate - Commenls Signature Date . . th/nodoo?q? +0 ax? -. - I h?fl?'kif'rti? Lulu/Lot away Maia/tie 'l-o - a 1.0% 0V1 41.. . Wot/{- /0 3' 435? (m an 0.25%le 3m; [6.231% 30 Van Mun-L Lo Mme-dob. 4 to gage:an b?ZOmfi Mumm?k?J?x Wm 51% l. illol-ILZ?J 1W *0 peeinggb - Continued/Additional Comments by Regional Director/Designate Comments Signature Date I i if MW NIP .. 521(1) Distribution: Original - Regional Director {Only for Regional DIraclorRel/iew) - -- Copy-inman Fitn- - I - CSD 075-100 (1 0104} 000304 Cgbtu . i Ministry of Community Safety Segregation Decision/Review and Correctional Services r; .- pi) Ontario err-i Institution/"P. ?Far-(s Central East Correctional Centre i Name (Last. First. Middle) - . i Client Identi?cation My Reason(e) tor Segregation i:i Protective Custody institution Security Medical inmate Request Date of Segregation 29 Sept 14 inmate advised of reason [or segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity for interview with Superintendent Inmate waives oppo?urlim Interview with Superintendent Name of Superintendent/Designate (Print) Signature of SupWate Date Sgt. K. Stoifers 30 S_ept 14 - Superintendent Decision, (This section must be compteted within 5 days of the Inmate's placement in segregation} inmate SLibmi-seion IIM admitted from 50 - head watch -'assualted on unit Superintendent Decision Release from Segregation I ContinueSegregation Reasons: - {UL-tote} cJ a [m coo?JI'W? am-?a?m Name of SuperintendenUDesignale (Print) Date. Signaiuw?imesignaie con-v- M- Sermon Review (Inmate?s segregation to be reviewed every .5 days. interview with Inmate to be conducted every 30 days) inmate Submission Release from Segregation Continue Segregation Superintendent Decision Ci Reasonsz' I Name of SuperintendenttDesignate (Print) - Signature of Superintendent/Designate Date Kreeoccm amt 5 loit3l "9 Supplementary Report for each Subsequent 30 Day' Period (use reverse offarm rar additional comments) Comments SuperintendentlDesignete Signature Date 521(1) CSD 075-100 (10104) 000305 Regional Director Review Page 2 Continued Segregation Supported ID Not Supported Comments 30 an; '40 WK swap-kw 3-5m?v?-qp. Name or Regional DirectorfDeslgnate (Print) Signature of Regional DirectorlDesignate Date Gee CG 19? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments 7 Comments Signature Date . In dry? an I 203'?ny f? (mil?Gk..- 5* Mid am il/ote/Af Continued/Additional Comments by Superintendent/Designate . Comments Signature Dale 2?9 Malta/lull?15 Mme! +0 ?666. /0 2" LP fD/dev_w I . . xt/rvmaJLQ 7L0 I V- 39 A173 'cwm' 74L r? [0'36' Continued/Additional Comments by Regional Director/Deslgnate Comments Signature Date - s.l\llR 521(1). Distribution: Original a Regional Direacv Regional Director Row?ow) Copy- Inmate Fila' CSD 075-100 (10f04) 000306 Central East Correctiona? Centre for 30 Day Segregation Reviews Inmate Name;- - OTIS Number: Inmate written submission for 30 dev searana?nn mulng - Inmate Oral Submlselon for 30 day segregatlon review: (To be completed by Segre tion Manager) 60:th Leora/O vow - 7i) Eggnog} 4m Sam/.7 A ?0 umCG/Aa/ mat 44mm. s.21(1) 0 . 0 I . Inmate signature: Date: October 29. 2014 WItnessName: _S.McWh nn e .- Wltnese Signature: 0 000307 - . - outi . . . . . i? of Commy?gyg?gietv - Segregation Decretoanthew and Corra??fionahsillig, ,4 i ., . - \f?ga. - g, . - I instilu'on Catt Central East Correctional Centre - Reason(s) for Segregation Name (Last. First, Middle) Clie?Hd No. Date of Segregation 09 Aug 14 Protective Custody i] Institution Secudty El Medical inmate Request Inmate advised of reason for segregation Inmate advised or opportunity to make oral or written submissions Inmate advised of opportunity [or interview with Stiperinlendent Inmate waives opportunity with SUperlniendent Name of SuperintendenttDesignate (Print) Signature oiwuoesignate Date Sgt: K. Staffers 10 Aug 14 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission . Admitted from 5 pod - pulled from unit and asked to sign PC which he refused and thenljrequested segregation ?3351's:qu Bit. kg. yon-6 o. ?amawok at. nods-ugh: 0Q VM 8% ?Na. ?no.5 huh-xx aw ?who: i I Swerintendent Decision Release from Segregation ContinueSegregalion Reasons: Mg?. 9 ?3 93 rife: (.1- #5 - (Par/mob) Wu? 5 c??rr" Name of Superintendentioesignaie (Print) Signature ofSupar' le esignate - 5729 (7.5ng . - Dale com! 87/ 97/ 5; Segregation Review {Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision Continue Segregation El Release from Segregation Reasons: - caged - Name at S'uperintendenUDesignate (Print) Signaturaof Superintendenuoesignate Date 5?r-?eex? gen?M Supplementary Report for eaoh Subsequent 30 Day Period (use reverse afform for additionaioomments) Comments Superintendenuoesignate Signature Date i s44i2lid) 521(1) i 030 075?160 (10/04) 000308 Page 2 Regional Director Review Continued Segregation Supponed Not Supported Comments . Name of Regional DirectorlDesignate (Print) Signature of Regional DirectorlDeslgnate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form [or additional comments) - Comments ?%naturej Date (3'3 - - Ore-V 6409m"55?f01,wca I I - l. gentinuedlAdditional Comments by SuperintendentlDesignate - Comments Signature Dale MMIddIyy-yvr (as/zq/li t, Mg No.1 a (Maia #3 Fwd.th MW 52g Y/iq/ (qr; RC. 9 mmwmutww 30 5w in ?C-L?nii- 1Uwa Mgrw'f??o Kev/7%) cit/n? Land - (ac/12m waz'yy?ohdg?zgq w. Danes M+ch?f?clc??mu . 7 a; haematite eh M3. See? Continued/Additional Comments by' Regional Director/Designat (D Comments Signature Date MMIddIyyvy s.NlR 5.21 (1) i Distribution: Original - Regional Diradar (Onlyror Regional Director Review) Copy - Inmate Filo cso 075-100 (10104) 5 000309 7,0 96 Regional Director ReView Page 2 Continued Segregalion E- Supported Not Supported Cpmmenls 5-46 m1.? Cain- Name ofRegianal Diredorloeslgnale (Fran Signmum of Regional Diredgrloesignale ?g?af Dale 'a?/f/ch?c Suppternentary Reporl for each Subsequenl 30 Day Period (use bottom of form [91 addi?onal comments Comments I . Wm Dale 939% ~74. Mth-oa maC-E? 44w LA Ora?Q'ocdgm'quflw f! . Mdelyyw .15:th Cy. Con?nuedlAddilionai Comments by Superintendent/Designate Dale Commanls Slgnaluna yak?: W0 Luau! cm vphupig', be - as/Z?f/l?nl SUJD tr ?an?3' Mag/1W 0:6 .H. -: . v-Cu 1% 7?6 ndomlcjadgdm?h P- WoCan La fat/a . 56: (1-6. Mme-F? a 723 Mu} - Lm?tfam m?mw?c?? 01012 1:10 473.9,. 9 MM Continued/Additional Comments by R-egional Director/Designate Comments Signature: DaIe_ - 321(1) Okinawan: 0mm! - Regions! and?: {OaVlem?nal Dirac-1R0 v?w) Copy-[mu ?le can 075?100 (10/04) 000310 Distriot Ad minieirator Review Not Suppo?ed Page 2 El Supporied ConlinuedS?gregaiion Comments Name-of District AdministratorlDesignale (Print) Signalure oi Dale . Supplementary Report'for each Subsequent 30 Day Period (use bottom of form for additional comments - Commenls Signature Dale AQ/eb/k/ Xv?i?ly?/ 5,5 73/ ea, .JM 11?; SK Lin-v.9.? a Lo mm. Continued/Additional Comments by Superintendent/Designate Comments Signature Dale . LIL 5rt. ?40% Own-D I I r6 - q?b Khmer/Jaw - LEI/wow bf 19/03/14 KN I ?10 "1Lo Vm Wham \ro taco-L"? \OQMdouAag Comments by District Administrator/Desi nate Comments Signaium Dale A MMIddM/yy . . New MM Jim? Vim s.21(1) 5-21 Dislnbullon: Original - Blair-d Adminlsiraiw Raw-ion!) 080 075-100 (10/04) 00031 1 go alo Regional Director Review Page 2 Continued Segregation Supported Not Supported Comments 50 E424) ??g/19340 0?31- We 3% :?Landlo'alou Name of Regional DirectorIDesignate (Print) Signature oi Regional DirectorIDesignate EDEN sir?Q" (J Dale ?/Io/Zolsr Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Clo '66 I 12.57 out: be UJMLC AWL, JL JVL - JavierI/Zoo/ch a} More 11199;?. ?Lao-1+ ContinuedlAdditional Comments bv Superintendent/Designate Comments Signature Date +01 . Jame 03. was? ?Mo 16;, 7 i tweeters/(maxi em. xo-zw 4.19 Vt A U'n Gap Lawl- 4- A4434 4, ca 13) a 2c, Lowe, a Zeno/.1 49? . and adwk' Continued/Additional Comments by Regional Director/Designate - Commenls Signature Dale 9.1m. Distribution: Original - Rog'tcrial Director (0an forRogional DTaotorReviow} . File 050 075-100 (1oro4) 000312 centrai East Correctional Centre inmate Submission for 30 Day Segregation Reviews Inmate Namez. OTIS Number: Inmate written submission for 30 day segregation review: {Ki ~1~n KA - \W?pg? i . i . Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) Vm .gikhj Vu (mm gAaJimk-u (MA 3? i otk (Lamar [/13 guy in analog/i PC- '3,ng mm Lgm?lvi?? Liv-i (mji 0U do?. lnmate signature: - Date; o2: - ice Witness Name: 9x. M. Sra ice-615153 Witness Signature: 000313 ?fc?mmuniw Safety Segregation Decision/Review - and Correctional Services I I A Ontario 'iUS-iO-tu?Oi IPA XEQ . ?Kin it t; mite Central East Correctional Centre Name (Last. Firsl. Middle) ?2 - Client [Bent-Wombat;th CecC- 3 _Heaeon(3) tor segregation - Dale of Segregation - . - . - 028ept14 Protective Custody Institution Security Medlcal Inmate Request 8 Inmate advised of reason for segregation Inmate edvlsed ol opportunity to make oral or written submissions Inmate adviser] of qppo?unliy for interview with Superintendenl Inmate waives for Wilh Supaflnlemenl Name of SuperintendenUDesignale (Print) . Signature of SuWeeignale Dale Sgt. K. Staffers 05 Sept 14 . Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation). Inmate Submission IIM admitted from 3 pod - bizarre and unusual behaviour Superintendent Decision Release from Segregation Contlnue Segregation Reasons: (EmbaeL-i' 0303:: not. @ro'fdrtev?x Name olf SuperintendenUDeelgnale (Print) - Signature ol SuperintendenUDeslgnate Date . - Segregation Review (Inmate's segregation to be reviewed every 5 days- Interview Inmate to be conducted every 30 days) lnmale Submission 7 I Superintendent Decision Release from Segregation Er Continue Segregation Reasons: - - I W. Name of SuperintendenUDeslgnele (Print) - Signature of Superintendent/Deslgnale Delta 7 SMUQRNWE i - Supplementary Report for each Subsequent 30 Day Period (use reverse orrorm for additional comments) Comments Superintendentloestgnete Signature - Date I ?(own 5,21(1) 030-075-100 (10/04) 000314 SO Pitch? ta 5:4 It: Amok Jro't an - - _antinuedlAdditionaI Com by Regional Director/Designat Regional Director Review Page 2 Supported _Conlinued Segregation Comments - Not Supported Erna of Regional DIreclor/Designale (Print) 011m maul Sabch dew We. L- (-1er 47A ??a?Ji/Lt Signature of Regional DirectorlDesignate Date Supplementary Report for each Subsequent 30 Day Period {use bottom 'of rogue; addj?onal comments - Comments Date 30 A . - -l'o prewar; mm to .V Continued/Additional Comments by Superintendent/Designate 75/46/44? Comments Signature Date - [32 growl, 5M . u.an \oakad't oko uo?k. goci Lo. $0311,? o. 5AM. elm/+4 .09/24I/1t-? be. a Luna-aw Eekmv?tomv . a; @532 \3 3 bkomomv Beoom\n?\ mow-t, o?ija?t/r4 Bazaar: Mel-among ke?w 1'squ ?thcketo? kct?nb newt. a $33 Joljoq/IHL Comments t'D Signalure: 430.5 mote-tw- \93 ckaWm . Date A 1 1 AL s.21(1) Dismhutl on: Original - Regional Dlreclor (Unryfor Regional Director Review) Copy - Inmate File CSD 075?100 (10104) 000315 District Administrator Review!r Page 2 Continued Segregatlon - Supported Not Supported Comments 6 DUEMESSEW [1 3?1 Signature of District AdministratorlDeeignate Name of District Administralo?Designate (Print) Date Suppiementary Report for each Subsequent 30 Day Period {use bottom of form for additionalcomments) Comments Signature Date . - . - ,r - - Gunny-m0!) aft?iwa-Nf?kg?v?o .CWS [100% Dug-,0 . Mal'l?ur??tif?fb?ljtw J4.) a. ?4,197 0 /4 mum rah, cm?: 5 ?fty?me 471 a 4.4" Continued/Additional Comments by SuperintendenUDesignate Comments Signature Date - NV a . V?u?r?w 1?3 'P'EHchyo?w?pl - I a We, 1- wbaew 7 3 . an l0, Jim} 4 +0 um. ,Ccui-b . - 7 bc. CLUFOLUM I . 2- cM/u' whim/m4. ?pas-5.3% JamgME-y? (:1va I . ccfo.? 445 54? I. . . Jmf?c?S/L? Cir/18.45 I 03 mbj-bfzw QJVUCn-vnumf 6m m?'aa? I Continued/Additionat Comments by District Administrator/Desi nate - Comments Signature Date s.NlR se21(2xr) Dlatnbullont Origtnat - District {0an lorDism'ct Admtnistrator Review) Copy Inman its CEO 075?100 (10/04) 000316 Centre! Eaet Correctional Centre Inmate Submission for 30 Day Segregatlon?evlews l'nmate'Neme: ons Number: Inmate eubmission for 30 day segregation revlew: s.21(1) Inmate Oral Subm esloh for 30 day segregation revlew: (To be completed by Segregatlon Manager) CE- mc't/ MUM. m3 om:- umsaic Jxlo [In Jw' . - . . ?nga?WAZ 0?3 (EM gram-n6 613] 1 50 ylcdawn 261/1qu I I I I {2.521% lnmatesignature: Date: November3L2014 Witness Name: I witness Slgnature: 000317 . ea Ch ?3 - Ministry Safety Segregation Decision/Review (?Ni if: institution .. . :5 ,Gen ral East Correctional Centre Name (Last. First. Middle) Clienlldehti?oallon Reason(s) for Segregation Date of Segregation Protective Custody institution Security Medical '3 Inmate Request - 05 inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions inmate advised of opportunity for Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name ofSupetlnlendenUDesignate (Print) 1 Signature oiSuperinte' nUDesignate Dale Sgt. K. Stoffers 11 July 14 Superintendent Decision (This section must be compteted within 5 days or the inmate?s ptacemant tn segregation) inmate Submission I Admitted to segregation from 20 unusual behaviour - upon arrival to segregation stated he wanted to harm_himself and placed on suicide watch. - . Superintendent Decision [3 Release from Segregation Continue Segregation Reasonsrl I 724mme ow - Name of SuperintendenUDeelgnate (Print) Signature ofSu eti entiDe ignale . Date . Sap-'1' 42. 97:61?an lr-Qul-7-l Segregation Review (Inmate's segregation in be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation I Continue Segregation Reasons: . ?lm/nap} 0'71 Apt/cl; Name of SuperintendenUDeslgnate (Print) Signature of Sup Designate - Date seer Swept??05% . . ev/lb/lht Supplementary Report for each Subsequent 30 Day Period (use reverse ottorm toreddiitonatjcomments) Comments I 7 - Superintendent/Designate Signature Date s.NlR' s.21(1) t! can 075-100 (10/04) I II E) 000318 ?Regionai Director Review Not Supported Page 2 El Suppoded Conllnued Segregalion Commenis Dale . Name of Regional Director/Designate Signalure of Regional Dimmer/Designate Supplementary Report for each Subsequent 30 Day Period @se bottom 9%di?onal comments Comments - nalure Dale ??zixrv??ddrl ?543 u?f? ?3 4 ,4313?f . f? r? Continued/Additional Commehis by Superintendent/Designate . Comments Signature Date AW *1 Mwb?f?m. 137/? p4. LAJ/mcc?vm Rama-M mm Loni-d3? . Wag/@121 29/14; 3' all/LI . ?Magus U/WLO/Y?rl?vxl/?f mama 30 ?qugbka-hq 50-: \Dt/koub?c uhavaLJQ?wh 'kaf??1? Qt: ugh! osjoSfIiLi' libin ?3 {tow P?fwi?d-?L av wk hum Lou?M Cue-.4 me??k (D Signature Date Comments by Regions! Director/Designat Commanls s.21(1L Copy lnmale File CSD 075-100(10104) Dlsl?bullan: angina! - Regionai Director (Only (orReglanal Review) 000319- Regional Direcioi' Review Page 2 Continued Segreglion quponed CL Nol Supported Commenls Name ofReglonal DireclorIDasignate (Flint) Signaiure'of Regional wrecker-[Designate Dale oEZOE/Zoler Sugplementary Report for each Subsequent 30 Day Perlqd (use com'menf's [a Comments alute Dale I i i I A MdeImy Continued/Additional Comments by Superintendent/Designate . Commenls Slgnaiuro . Dale - MWer ?4?1 44.11.} a) ay/m/P-L. Wc?: LucuLdL 0h 7 TE WNW 16.4.6} .000 AM [4 web/n3 /154'4gb a. 50 ?Peqeukogq Mme-wt. - ?lm?s ?woke-4 CSD 075?100 (1am) 3 we, 53? "J'cb?wr'di 4 te?W was/MM- m'??kuw - 9-4 was-\zoJ- - Luv-devx?aa-O?JB LL'vm wage?06??va ConlinuadlAddilional Comments by Regional Direclor/Dealgnaie - Commanis Signawro Date I san?d)? s.21(1) DIE moullan: Original - Rmiennl Dire-act {any Ipr?cghnalmcdar Rev-'an Coyy- Imma- We 000320 M?gionalDireclor'Review Conlaned Segreqallon Commean ?0 . - OWL - 33599-ch . i SUpportad N01 Supported Page 2 M1 3 PI Saw Q?s-94?. em?kc?? of Regional DIradot/Designale a Signature 0! Regional DfractorIOeslgnaleU Dale I I a Continued/Additional Comments by SuperintendanilDasIgnalar - 6w .?ma?C d?jwf'on asilipplementary Report for gi?itlfsequem 30 Day Periodfgse botfom?p?l?hfonal comments 7 re judo u? Jusm?gmk g?g??h?j ~54? C7 ?at/M II . I: [Wu?Lat . uJ-a?kafj? may-u: I - Dale Commenls Signawro' 95.; lb? QnLaJ-{kg? a earnwg, ?why lunacy? ?AW?dw? a?g On in. 6212ng 1?51?; Jul?mmh?: {0 6:11- ?-grmj (4:45 s. m; Mbddam-k: (imam 7 w, I I 1 13L: mu, (CHH . waxed Ul?n?n?dlm?llion??l Comments Red onal DlreclorIDesignate I Comments Signalura' Dale . MMIdemry 21(1) can 075-100 (10104) Dl:l?hullon: Odgmf?egbg?O'udor lnmale Filo 000321 GS ?70 26 qt) - Regional Director Review Page 2 Continued Segregation Supported NotSupponed Comments [It Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form additional comments Dam we oat/a?oat? Continued/Additional Comments by Superintendent/Designate Comments Signature Date .. MMIddeyyr amt-(9? wear?24> at? do . again; EDWW Matron-navy? PW . . Req9mm oral/241+ a.?o?uk_ 53 oak draJua l??i?x?L :34} "Reamnb er ?mourn {MagdL oq/Zqi?q Continued/Additional Comments by Regional DirectorlDesignate - Comments Signature Date?Tr? r? Ma .?a/ou/z ?r I MO 'm?u?UL. 5mm - A Aln\l_l\ a. I?I?Lnul Dislnbution: Onglnal - Regional Director (Only for Regional Diredal Review) Copy - inmate File CSD 075-106 (10104) 000322 IZO loo log7&9. It; J. mo lung. Oer ALme urn attain . Regional Director Review Page 2 Conlinued Segregation Supported Not Supported Comments [2.04% Mei/W43 mSMt?m Name of Regional DIrector/Deslgnate (Print) beet-J Signature of Reglonal DirectorlDesignate . 497. Dale Supplementary Report for each Subsequent 30 Day Period (us bottom of form for additional comments) Comments Slgnature Date LC Mb must-roam . moi" .?sg - Ditto?C 0 mail! mph?P, ~b d?magwm?eq - 1 art/L [mt/1% ContinuedIAdditional Comments by Superintendent/Designate Comm ts ?na ure ae an 319' 1 In,me Ee?Lw%h (?n/?Log 32? 10?1?. [94 ?Shim M- e. allow th?C - . (pt?Moan 36 5 [074"? ?momma: . (Cf '03! Comments. Continued/Additional Comments by R_egional DirectOrIDesignate Signature - Dale 521(1) Dlst?butlon: Original - Regtonal Director Regions! (Di/ado! Rev-fa w) Copy - Inmate C30 (575-100 (1 0104) File 000323 Central East Correctional Centre inmate Submission for-30 Day Segregation Reviews OTIS Number: ln-rn'ate Name: Inniate written submission for 30 day segregation review: - Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Mane er) '3 {a 199. ?amers-f D0723 h/o-i LL)ng 47) cmowvxd art/km. Loan/15L, or' 3M lnn?iate signature: Witness Name: 8. McWhinnie Witness Signature: 95 Date: November 31 2014 I smUR 000324 I I er Ontario, Ministry? Segregation Decision/Review Correctional Services T1 O__i C) :3 a (?er-c ?5 EASTCORRECTIONAL Name (Last. First, Middle) Client Identi?cation No. 2/ Reason(s) for Segregation - ?Date of Segregation Protective Custody Institution Security Medical Inmate Request-"Ir . ?oat?2014 Inmate advised of reason for segregation - Inmate advisejfpponunity to make oral or written submissions El Inmate advi5ed of opportuntiy for interview with Superintendent - Inmate Halve poonunity for interview with Superintendent I Name of SuperintendentIDesignate (Print) Sign rintendenUDesignate Date Ed Newman - 15-Oct-2014 Superintendent Decision (This section must be compieied within 5 days oi arm's placement in segregation) Inmate Submission Inmate displaying bizarre behaviour. Inmates do not want her in with them because of this. Has peer problems. Superintendent Decision Release from Segregation Continue Segregation ReaSOns: Placed in seg for her protection and will see someone from the depart Name ofSuperintendent/Designate (Print) Sign reof up tandem/Designate Date Ed Newman 15-Oct-2014 Segregation Review (inmate 's segregation to be reviewed every 5 days. inmate to be conducted every 30 days) Inmate Submission 7 gm? was Mr ?fw? Superintendent Decision Release from Segregation - El Continue Segregation Reasons: Wino-0 WW Wm Name of SuperintendenUDesignate (Print) Signat dent/Designate Date - A 9 . NW - {90777/ . Supplementary Report for each Subsequent 30 Day Period (use reve 5 form for additional comments) - i Comments . SuperintendentlDesignate SignatUre Date . . DaylMonth/YEar . W?w duz 1-0 I A ocuJets/W - 697/? Ana050 075-100 (Deitisj 521(1) - 000325 I - Page 2 District Administrator Review Continued Segregation Supported Not Supported Comments 32cm: . 0* to ass-r: 00 Name of DistriCt Administrator/Designate (Print) Signature of District Administrator/Designate Date Gee-Gr Suppiementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Day I Month I Year I l' Continued/Additional Comments by Superintendent/Designate - Comments Signature Date 1?7" Mme? Wart/Wt?; 27/M/za? a; a?mwm tam/xi; AW A - I Continued/Additional Comments by Distn'ct Administrator/Designate Signature - - Date Day I Month I Year Olslributlon Orlalnal - District Administrator (Only for District Administrator Roviow) Copy - Inmate Flla cso 000326 he) Migisciry Safety Segregation Decision/Review . an Iona BWICES . Ontario tug no 1- ~01 - Institution f? . (tumbling, min: 35. trei East Correctional Gem i?Name (Last. First. Middle) ww? (client Identi?cation No. Reason(s) tor Segregation I - Date of Segregation . . . - 30 Sept 14 Protective Custody Insiliullon Securliy [3 Medical A Inmate Request inmate advised of reason tor segregation inmate advised of opportunity to make oral or written submissions inmate advised of opportunliv ior interview with Superlntendent Inmate waives opportunity for interview with Superintendent Name ofSuperintendent/Designate (Print) Signature ofSuporl ten Desi nate Date Sgt. K. Staffers '03 Odt 14 Superintendent Decision (This section must be completed within 5 days of the inmate 's placement in segregation) Inmate Submission . t/M admitted from ASD on suicide watch Reasons: - remains on suicide watch Name of SUperintendentiDesignate (Print) - Signalu?numsmnate Date Mlg'rorf?'m damn SuperintendenlDecision . CI Release from Segregation Continue Segregation Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted eVery 30 days) inmate Submission - Superintendent Decision Release from Segregation. i3 Continue Segregation Reasons: g? . Name of Superintendent/Designate (Print) Sig re of ups ancient/Designate Date r? I I - I I Suppiementary Report for each Subsequent 30 Day Period (use ?3%er for Comments SuperintendenUDestgnate Signature Date - MMidd?rm s.NiR mend) s.21(1) 075-100 (10104) 000327 Regional Director Review Continued Segregation Supported Page 2 Not comments 30 Submta? attacLA Lt,qu umL-QL-lw. I Saga-63km? I Name at Regional DirectorIDesignate (Print) Slgnalure of Regional DirectorIDesignalo Dale r- Mia/2.0; 9L ?Euti? . - Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) A Comments Signature Date - as h? too-44 own to, (Modal/mi Continued/Additional Comments by Superintendent/Desynate Comments Slgnature Date maWCx-y kg Mpaxr?vzpk ?lm WMQ moo-?a ~Jm-u9rmxz I ?jlq1IlL+ 051% v'aHchEeoayj - Capos-L '3 . e??t?tw? WW ?it - 10.10!sz ?m NW ?3?3 - m. NO mmt??t/ eta/kg (rttc??twb?)- . {ct-30; ?own to Pimcw?H' ermm ContinUedlAdditional Comments by Regional Director/Deslgnate Comments Signature Date 521(1) Original Regional Director [Only for Ragbnai Director Rem w} copy - Inmate Filo CSD 075-100 (10104) 000328 WItnessNamet S. 'nnie Centre! East Correctional Centre Inmate Suomieeton for 30 Day Segregation Reviews .lnmete Name: OTIS Number: Inmate submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: (To be completed by Segregatlon Manager) 7 . II SLNIR s.21(1) I Nov. 4.. Inmate slgnatur Date: OctobepaOrZO??l-k - Witness Signature: 000329 ?t i We) Ministry 0? 9?mmunit? Safety Segregation Decisioaneview Ontario and Correctional Semces Tnstitution gem C), . A Central East Co rrectio na Centre i Name (Last, First. Middle) Clie identi?cation No. Reason(s) for Segregation . . Date of Segregation Protective Custody Institution Security Medical inmate Request 10/1 0120134 El inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions inmate advised of opportuntiy for interview with Superintendent waives Opportunity for interview With Superintendent. i Name of SuperintendentlDo-signate (Print) Si ture of We Date . s. McWhinnie . El 10/15/14i Superintendent Decision (This section must be completed within 5 days of the inmate?s piece-mam in segregation) i Inmate Submission Subject states he fears for his safety on a GP living unit - refuses to sign PC - states he will be returning to the federal system and does not want to be PC when transferred Superintendent Decision [3 Release from Segregation IE Continue Segregation Reasons: . I . - To remain as per his own request I Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date 8. McWhinnie i 8 (Y) 10/15/20i1'4 i . Segregation Review (Inmate's Segregation be. reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission .i . I Superintendent Decision El Release from Segregation Ci Continue segregation - ReasonsName of Superintendi?nt/Designate (Print) Sig nature at Superintendent/Designate Date II - Io-Lolils. r- - . Supplementary Report for each Subsequent 30 Day Period (use reverse for additional comments) Comments I Supenntendth/Designate Signature Date I - . i s.21(1) I cso 075-100 (10/04) 000330 Page 2 Regional DirectOr Review .. . 0 Continued Segregation [2 Supported Not Supported Comments 330 I .l - Smog-c uri?HCm CDC-JEWIW Name of Regional DirectorJDesignate (Print) Signature of Regional Director/Designate Date @nuc 0? n/rg/zoro Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments} Comments Sig . Date? MMIddm I inmojm mi I I rm mWwM-Lon d. . . Continued/Additional Comments by Superintendent/Designate - - Comments Signature Date lqmmumf??L?s?ejfv?wmw 39/9 [ca-291+ (5f I in ash: 7b WW We 0?0 ~4mmcde?U??br 63/6If. Continued/Additional Comments by Regional Director/Designate Comments Sig nature Date I 's ?midi 521(1) 3721(2llf) Di;lribu?pn: original -_Regional Director {Only ror Regional Director Rewaw) Copy - Inmate File cso 075106 (10/04) - 000331 I Central East Correctional Centre inmate Submission for 30 Day Segregation Reviews Inmate Name: I OTIS Number: inmate written submission for-30 qlay segregation lrevievy: Inmate Oral Submission for 30 day segregation review: I (To be compieted by: Segregation Manager) I 3 Inmate signature: Date: November 9, 2&14 Witness Name: 3. McWhinnie Witness Signature: {956%} I 000332 5? Ministry of Community Safety - Segregation Decision/Review . - and Correctional Services a Ontario - tags-19w Lino! I 54% . as Central East Correctional Que Name (Last. First. Middle) Cm?m?mb Reason(s) for Segregation Dale of Segregation . I 10/09 014 Protective Custodi El Institution Security Medical Inmate Request ,2 Inmate advised of reason for segregation - Inmate advised of opportunity to make oral or written submissions a Inmate advised of opportuntiy?for interview with Superintendent Inmate waives opponunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date 8. MoWhinnie C390 10/10/2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission Subject requesting segregation - Superintendent Decision Release from Segregation Continue Segregation Reasons: Subject admitted to segregation upon arrival from Admitting and Discharge at his own request Name ofSuperintendentIDesignate (Print) Signature ofSuperintendent/Designate 7 Date 3. McWhinnie . 8m 0043M 10/14/2014 . Seg regation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision El Release from Segregation . CI Continue Segregation Reasons: +0 Mum?_ Name of SuperintendentlDesIgnate (Print) Signature of Superintend Designate I Date 5/0-1944- Supplementary Report for each Subsequent 30 Day Period (use reverse arrorm for additional comments) - Comments Superintendent/Designate Signature 'Date - s.21(1) CSD 075-100 (10/04) 000333 Page 2 Regional Director Review - Continued Segregation IE Supported Not Supported Comments Name of Regional DirectorlDesignate (Print) Signature of Regional Director/Deeignate Date - 59f $74, 1 Supplementary Report for each Subsequent 30 Day Period (use bottom of form comments - Comments ?y?mre Date 30 41 - . 1 I MMIdd/ym I 0V.) . i 6 (. fr .914 moi/7L I u;de (mm/.11 (M 0110. I Continued/Additional Comments by Superintendent/Designate i Comments Signature Date inmmuj?a?x?fo?m?dv WM [0.24.1.4 quorum; cud? (a lo .29qua-XI. 11'0521?6 . . . IoContinued/Additional Comments by Regional Director/Designate A Comments SignatUre . Date s.21(1) Original - Regional Diric?mf for Regional Diracror Review) Copy - Inmate File . CSD 075-100 (1 0104) 000334 Gentrai East Correctional! Centre Inmate Submission for 30 Day Segregation Reviews inmate Name:_ Number: . Inmate written submission day segregation A 521(1) Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) lnrnate signature: Date; November 9. 2014 Witness Name: I S. McWhinnie Witness Signature: 000335 We) i Ethel Safety Segregation Decision/Review - ahdt ?tel? ervices Ontario Hie-1&1 i Central East Correctional Centre Name (Last, First. Middle) lient Identi?cation No. My A Date of Segregation 10 Sept 14 Reason(9) tor Segregation Protective Custody Institution Security Medical Inmate Request Inmate advised cf reason for segregation inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity tor interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of SuperiWesignate Dale Sgt. K. Stoffers 11 Sept 14 Superintendent Decision (This section mustbe completed within 5 days of the inmate?s placement in Segregation) Inmate Submission l/M requested segregation functioned on unit while at CNCC but refuses to go to a regular unit at CECC Superintendent Decision Release from Segregation K1 Continue Segregation Reasons: . MW *0 g?iu??t? Name of SuperlntandentlDesignate (Print) Date M??onpg?s. 09/19/14 Segregation Review (Inmate 's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Mw? to MM m, Superintendent Decision Release from Segregation Continue Segregation - a. may x162 some. Date - dilate/let Name of SuperintendentlDesignate (Print) . Signathdent/Designate Supplementary Report for each Subsequent 30 Day Period (use reverse ofform for additional comments) Comments SuperintendentIDesignate Signature Date sli!414 cso 075-100 (10/04) 000336 16 go. :95 3?5 3?t Regional Director Review Page 2 Continued Segregation El Supported Comments Not Supported LAM 9:59.26. - Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date A . . - - iawv? rth-- jo?k?e Continued/Additional Comments by Superintendent/Designate . Comments Signature Date . . {Ramme Mad o?i/szt/L/ T) a. bra?:3 cam-k115i cLi/J ad. me off OW) oat/sol/ML I I :3013/144 Continued/Additional Comments by Regional Director/Designat (D Comments Signature Date . - IOIIQIILTP s.21(1) Original Regional Director (Oniy for Regional Director Rat/Ia W) Copy - Inmate Flle CSD 075-100 (1004) 000337 Regional Director Review Continued Segregation El Not Supported Page 2 Supponed Comments . Go ?CkAo?-l, Name of Regional Director/Designate (Print) 6353/ Signature of Regional DirectorlDesignate Date [13/20/49 Supplementary Report for each Subsequent 30 Day Period (use bottom of fa Comments 690 I rm radditional comments ?nature Date Au.ij +0 meager/mo we. 14-A03 ?55 Law Mung Camw 0L0. may/AC Laue WW it 00;. (LL 1 +9 (#37 worr?etf CLboud?: .anJiAS .945- ?20ch fl. Continued/Additional Comments by Superintendent/Designate Camments Signature Date . jig/C [0.251111% Immaip I - 0 ?ll6:440 c. ?0 gieuk? mall (3&1 07147] Continued/Additional Comments by Regional Director/Designate . . Comments - Signature Date . Dln?bution: Original Regional Director (Only for Regional Director Redraw) Copy - Inmate Flle cso 075-100 (10/04) 000338 I 5' ?in'rgef submissien for 30 dyfsegregation Teview: (To be eompieted by'Segregation Manager) . i a Central! East Correctional Centre Inmate Submission for 30 Day Segregation Reviews ?nmlete Name: OTIS Numberi- inmate Oral Submission for 30 day segregation review: Mao mdb. 7122 mj?fab. calm/n acker m?/Ce 30073 #0 (?Kgql?-fzm 419 c?mt" . . Inmate signature: Date: November 9. 2014 Witness Name: 3. McWhinnie Witness 5.21m 000339 i: . :Kr so Segregation Decision/Review i9" Ontario i (Huang Q) {Institution (Central East Correctional Cent Name (Last. First. Middle) Clie?ntJWIj? N0.J Reason(s) for Segregation Date of Segregation Ci Protective Custody Institution Security Medical Inmate Request 10/09/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submiSsions Inmate advised of opportuntiy for interview with Superintendent inmate waives opportunity. for interview with Superintendent Name of Superintendent/Designate (Print) - Signature of Superintendent/Designate Date 3. McWhinnie . 10/09/2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission States he was jumped on 1 Pod SLyJerintendent Decision [3 Release from Segregation Continue Segregation Reasons: Subject admitted to. segregation on a head watch after being beat up on unit: inmate is requesting to remain in segregation at this time as he fears for his safety Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date ii? ?4 ?5 10714/2014 Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation . - Continue Segregation Reasons: I +0 Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date . I [0?i?izl?i' Supplemented Report for each SubsequentSO Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date MM/dd/my 21(1) 050 075100 (10i04) 000340 I Page 2 Regional Director Review Continued Seqreoation Commente?ocLO-O. Supperth - Not Supported Date Name of Regional Dimmer/Designate (Print) Signawre of Regional Director/Designate each Subsequent 30 Day Period (use bottom of form Madditional comments) Comments ture . CL ?14? I I I melaet'l? ago-an W74 - Mma- - Date MM/dd/yvyy [1.09.14 Supplementary Reporthr Continued/Additional.Comments by Superintendent/Designate Comments Signature Date MM/dd/ywyr Mamba Ae +0/U/m624m? ,5 . Q9, A meet/?f mite -Srd/mL- e? - 9? 'm (av-29-4 um) {mu ?re-n mm ?5 le?v? ,m i?.oe.2+ 5% HM W?h?as til?c, Ways-?5.. ?.64 conic/L . Continued/Additional Comments by Regional Director/Designate Comments Signature . Date s.21(1) 04 .E Original - Regional Director {Only for Flegianal E-irecmr Review) Copy - Inmare File CSD 075?100 (10/04) 000341 Central East Correctional Centre [Inmate Submission for 30 Day Segregation Reviews Ilnmate Name:- OTIS Number: inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) 521(1) Inmate signature: Witness Name: S. McWhinnie Witness Date: November 9. 2014 000342 6-: if?? Segregation Decision/Review I a re . *5 Ontario - ?ieroww'?r I Institution - FAXE msCentral East Correctional Centre I Name (Last, First. Middle) ES Cllent identi?cation No. Reason(s) tor Segregation Date of Segregation Protective Custody Insliiutlon Security Ci Medical Inmate Request 01 sepl 14 . . Inmate advised of reason for segregation Inmate advised oi opportunity to make oral or written submissions inmate advised of opponuntly for Interview with Superintendent 4 Inmate waives opportunity for interview with Superintendent Name of SuperlntendenUDesignate (Print) - Signature of ndlenUDesignate Dale Sgt. K. Stoffers i 2 01 Sept 14 Sup erintendenl Decision (This saction must be completed within 5 days of the inmate's placement in segregation) Inmate Submission - . . IIM admitted from - unusual and bizarre behaviour Soperinlendent Decision Release from Segregation Continue Segregation Reasons: - Name oi SuperlntendenUDesignate (Print) Signature of Superln ?gnate Date - oS/ov/le/ Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days] Inmate Submission SuperintendentDeclslon Ci Release from Segregation Continue Segregation Reasons: ?aw .Lw' . Name of SUperintendent/Deslgnale (Print) 7 Signature omesignate Dale - ?3 /r it I Supplementary Report for oath Subsequent 30' Day Period (use reverse orlorm {or Comments SuperintendenUDesignale Signature Date - stN/R 511(1) (:50 075-100 (10164) 000343 Regional Director Review Continu edSegrggaiion El Suppoded Page 2 Comments 20 3&1 As Sacaamuhout Not Supponed Date Name of Regional DirectorlDesignate (Print) QM Signature of Regional DlrectorIDesIgnate Supplementary Report fer each Subsequent 30 Day Period [use bottom of form fggacjditionat comments Comments I I I I Wire Misr\ ct 0rd q- '0 %waonu?o( aho?/xaguiw wi?oomwoirzw 4.134 ContinuedIAddition-Etl Comments by Superintendent/Designate 5 - Commenla Signature Date -I "g ?Im Mo,\b'I'Lga-Ni \oe?xadxoeug- Oq/Zvl/lq \ln?35 9?l' . I I 9?29 (9C54%; Oil/?1; ContinuedIAdditional Comments by Regional Director/Designate - - Comments Signature Date ., s.21(1) s.21_ Copy inmate File I 050 075-100 (10104) Distribution: Original - Regional Director (Only for Regional Drt'edorRevtew) 000344 Gentrei East Correctional Centre inmate Submission for 302 Day Segregation Reviews inmate Name: OTIS Number: inmate written submission for _30 day segregation review: Inmate Oral Submission for 30 day segregation review: s.21(1) - (To be completed by Segregation Manager) - 341L119 3 .Aoq opt?kc whim/(LL, bL. mau?cvth-Tkx. +0 Sta?{4 mm ie one . inmate signature: Date: October 1, 2014 Witness Name: 8. MoWhinnie Witness Signature: 000345 I rm Ministry of Communlty Safety and Correctional Services . 0" Ontario 0(0 77nuri?at0'r 954/ Segrelgation Decision/Review 5% a? - i 5H5 ?24 Central East Correctional Centre Name (Last. First. Middle) Cllent Identi?cation M). Rea30n(s) for Segregation Protective Custody Ci Security Medical Ci Inmate Request . Dale oiSegregalion Inmate aduised of reason for segregation Inmate advised of opportuntiy for Interview with Superintendent Inmate advised of opportunity to make oral or written submissions Inmate waives opportunll i 02 Aug 14 erview with Superintendent Name of SuperlntendenUDesignale (Print) Sgt. K. Stoifers Signature of Superi . 04 Aug 14 Dale Superintendent Decision (T his section must be completed within 5 days of the Inmate?s placement in 34 gregatton) Inmate Submission i Admitted to seg from medical observation - requires caneto get around i Superintendent Decision Cl Release from Segregation Reasons: cut/die}. to ?we {imp 53 Continue Segregation \a Name of Superintendent/Designate (Print) Signature of Su entIDe 'gnale Date A I M. s-m ace-6;- mm 1 03/03/2014 Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission i . . Superintendent Decision El Release from Segregation Continue Segregation Reasons: - 1 \a cam??Name of (Print) Date aid. ?70 Signature of Superintend ato- aslaa??m Supplementary Report for each Subsequent 30 Day Period {use reverse arranm rar Comments SuperintendenllDeslgnate Signature Date MMIddIn/yy s.NlR 3.21 (.1) CSD 075-100. (1001) 000346 A GraLaub Ml \h-u I - Page 2 Regional Director Review I Conilnued Segregalion E- $upportad th Swnoned . I I Commanlsgaow gm MA .30 daa Name of Regional DiredorlDeslgnalo (Prim) Signature of Regional 6?Ong LL Dale Supplementary Report for each Subsequent 30 Day Period (use bottom diam! commanls - Commean Si al - . /mob;?l?bl all-? U. Wk .36) main I ConlinuedlAdditional Comments by querlntendanvoesignake Comments Signaling: Dale - Wag, Mid/amt 3-D M-eo??i CALQ mm ?50 Mull Ir a - cm u-rutha caLw +412? mama-?Aw. ?fa/M Re IonalDireclorlDesignate Commang . Signnlure; Date . . - I s.21(1) -?nldnunom - may (0nqu mam Guy?Inmm?b Rom) cso 075400 (10/04) 000347 Page 2 Regional Director Review Continued Segregation Supported N'ot Supported Comments i i Name of Regional Director/Designate (Print) Signature of Regional DirectorIDesignate Dete i . i 1 Supplementary Report for each Subsequent 30 Day Period (use bottom offor or I comments Comments Si at Dale - . I - 4 t/j? Wd? I mJAy?rwd/m i wrmw/awmmaj? 1' Mo: him-e? 1/ i Continued/Additional Comments by Superintendent/Designate Comments Signature? Dale . v-cJa613 - - I, i Mazda ca? mm MAJ-LAM Ali?Q . . CM Marxme mob. Li Mel-mine wMamWw/sea ?i/n/rtl 1 (r i . ContinUIedlAdditional Comments by Regional Director/Designate . . Comments Slgneture' Dale Distribution: Original - Regional Director (Only for Regions! Director Review) Copy - Innate File CSD 075-100 (10/04) I - 000348 Page 2 Regional Director Review 7 . Continued segregation 8 Supported Not Supported Comments be la 1.. {if oukmcm?u UL. Name of Regional (Print) Signature of R?gionat?DirectorlDosionate Date . ?f . - Supplementary Report for each Subsequent 30 Day Period (use bottom of form fair additional comments) Comments tu Date . . I I we. Hem outh Oratz??ujw'ssm AtelgoJu .4435ij waxwa (Am?w 10.53.44, Contintled/AdditiOHal Commente by Superintendent/Designate Comments . Signature Date - . oqlz'lljl? .- jmob?; ??441.14: [kn-Jenn'e. . a - Moatbhait'mc' :29 :3ch u. 3?3-2 . - . 13.9. - I I Continued/Additional Comments by Regional Director/Designate A Comments Signature - Date 7 . - . . s.21(1) I Distribultan: Original - Regional Director {Onry (arm-glans! Director R?m'aw) Copy - Inmate Fita . CSD 075-100 (10/04) . 000349 Centrai East Correctional Centre [Inmate Submission for 30 Day Segregation? Reviews Inmate Name: OTIS Number: inmate written submission for 30 dav seareoatlon review: Inmate Oral Submission for 30 day segregation review: (Tobe completed by Segre ation Manager) - swam Lea mi awaken/Mme place. by; wo'th'LL4n - Mm Loewe/m c1th lnmatesignature: Date: October'i. 2014 521(1) Witness Name: .S.Mcw_hinnle Witness Signature: 000350 ?a - 3% I 1 . MiniStW-OfCOmmuniiY Safety Segregation Decision/Review and Correctional Services i i nstil?ulion . i a .1 Central East Correctional Centre ,i Name (Last. First. Middle) Wit/t, ~cnenr Identi?cation No. .. . a I I Reason(s) ior Segregation i Date oi Segregation Protective Custody Inslilution Security Ci Medical Inmate Request i 07 AUQ 14 I Inmate advised of reason for segregation . lnmale advised oi opportunity to make oral or written submissions Inmate advised of opportuntiy for interview wilh Superinlendenl Inmate waives opportunity or Imogen-with Superlnlendent Name ofSuperintendentheslgnate (Print) Signature ofSuPerinlendenU a Date Sgt. K. Sioffers - '08 Aug 14 I Superintendent Decision (This section must be completed within 5 days of the Inmate's placement in segregation} Inmate Submieslon I . segregation IIM - i S_uperinlendeni Decision El Release irom Segregation E1 Continue Segregallon Reasonslam? Name of SUperinlendent/Designate (Print) Signalure of Sup den eisignale Dale - . . I I 57:9 Fri-1296.5; wally/Jui? 5?5 Segregation Review (Inmate?s segregation to be reviewed every 5 days. lnierview wilh inmate to be conducted every 30 days) Inmate Submission lame ewe-3 +0 . 1 - superintendent Decision Ci Release from Segregation Ed Continue Segregation Reasons: i I . Name at SuperintendenUDesignate (Print) Signature oi SuperintendentlDesignate Date TimotOI-l/uurg, - 3il?/t+ Supplementary Report for each Subsequent 30 Day Period (use reverse afform Comments Superintendent/Designate Signature . Date . I . s.Nl I . 511 (1) CSD 075-100 (10104) 000351 Regional Director Review Page 2 Continued Segregation Supperled Comments i i CI Not Supported i I Name at Regional DirectorlDeslgnale Signature of Regional DirectorlDesignale . Dale i Supplementary Report foreach Subsequent 30 Day Period (use bottom of form for additional comments muck) 4:9 '15-le div? Ayes bot? Mbro-lcc?Izm [7 1 Comments 5/ Ignaluml Dale 1. . . . I MMIddf meta. a; i. WW I Continued/Additional Comments by Superintendent/Designate Signature Comments I Dale 2,2, Wee/45? ~st new? am f_ o?fal/Itf 35 Var/?4 4i .g?lw? ?*m?gw c, at: cOf?rq? ?g ?0 L) Napalm; Lo Quhw?tu .l?q O?llzoll'sfa. Continued/Additional Comments by Regional Director/Designate Comments Sig?nalure: Date -l - gcrojhw S.NIR s.21(1) cso 075-1oq (10104) Origlnal - Regional Director {Only for Regional 0mm Review) Copy - lrmale File 0003527 221Continued/Abdillonal Comr?enls by Regional Dfreolor/Designata- . - Signalu?F .Dale 514mm) 5 521(1) i Reg?ional Dlrecior Review Page2 ConIInUed Segregation Comments 30 AlmtuL??l In ?g Supported [3 Mel Supported Name: of ?glonal Dlredorloeelgnale (Prim) Signalure of Regional DIrecli-arloesignale ?at/3L Dale . 07/IK/Zdr?f Sumlementaiy Rgport {or each Subwem 3.0 By Period ?se bottom tailor/11:36:? addhional comments Dale stmx~l- 0?16 ?Ww?lwA?? . Commaan lgnmum:l 54.5.} qpr-ew'1 1E1, i mm 0 71.. . . i Or?qu? MW i 3/91/19 Continued/Additional Commenls by Superintendent/Daslgnata i Comments Signalurei Dale - 3 deMr . ?Sam I can 075.100 (10mg Olumbullm: Regional GYM (any Warmr??o?v) Co)? nmu. Filo .- In- -.- - 000353 Regional Director Review Page 2 Supported Conlinued Segregation Comments Go 0231.. 9031?, 9943 No! Sup??led Name of Regional DiredorlDeslgnale (Print) Signalure of Regional DirectorlD signala Dale Exam?l Of [elm/1e l?-f . Supplementary Report for each Subsequent 30 DiPeriod (use bollom ofberrn for agdllional comments . Comments Sig lure Dale I . . Deck/And) Drill . um mwa- ago ?9135/; .y 77/ I I Continued/Additional Comments by Superintendent/Designate Commenls'. Signalure Dale - ?5 MMIddlm? c.de be. .- - 09/29/?f Geoc97/1 AME e?W?-hkf? WM MW A flow-1 Barium- like"): 4, Continued/Additional Comments by Regional Director/Designate Comments Signalure Dale 5.21 (1 DisMbuilon: - Regions] Diredor (Only for Regime! Director Ra view) Capy - Inma'l CSD 075-100 (10/04) a Filo 000354 Central! East Correctional Centre inmate for 30 Day'Segregetlen Reviews - Inmate Name:_ OTIS Number: Inmate written submission for 30 day segregation revlew: 5 I @Am? (whet-A - I 521(1) . Inmate Oral Submission for 30 day segregatlon review: (To be completed by Segregation Manager) . i . . - Unjan 7 . - 1 i Inmate signeturM Date; 05" 1% . - Witness Name: . coral Witness?Signature000355 We; Safety I Segregation Decision/Review . - an orrec one . erv cee . . . . . Ontarto . . - - Me'iwcwi Institution/K *3 My 31 Qua] East Correctional Centre to I Name (Last. First. Middle) ??90 Client Identi?cation No. - Reasonfs) tor Segregation Date of Segregation . i 4 Protective Custody El Institution Security Medical inmate Rgtuesi 28 AUQ 1 Inmate advised of reason for segregation inmate advised of opportunity to make orator written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name oi SuperintendenUDesignate (Print) Signature of SUBMWIQMIG Dale Sgt. K. Stoffers 01 Sept 14 Superintendent Decision (This section must be completed within 5 days othe inmate'sptacemeni In segregation) inmate Submission Admitted from 4 pod on a hunger strike Superintendent Decision Release from Segregation Ki Continue Segregation Reasons: Mnge .JZA 0W Ge ?dz/?332m A4-it?L? Name of Superintendentfoesignaie (Print) Signature of SupetlnlendenUDesignaie Date a 6V3. A M?Sepliti Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to beeonducted every 30 days) Inmate Submission Superintendent Decision Reieasetrom Segregation El Continue Segregation Reasons: km bit/,6 hi1 Name of SuperintendenUDesignate (Print) Signatore of Superintendent/Designate -- Date gmtootiwme, - 55776., ojseptw Supplementary Report for each Subsequent 30 Day [Period (use reverse offon'n (or addt'iionaibommenis) Comments Superintendent/Designate Signature Date 521(1) CSD 025?100 (10/04) 000356 Page 2 Regional Director Review Continued Segre-gallon IZ- Supponed - El N01 Supported Commenls 30 A a ., an. gikh, Name of Regional Dlreclor/Deelgnale Signalure of Regional DireclorlDeslgnale Dale Gm been 535%., [om/204$ - Supplemental Report for each Subsequent 30 Day Period (use bollom of formlte-g comments) Comments Dale a . . - -A meal. +0 LLJ'U?L'b?lrvx or d?m Cun?pir-mia 'S'lrviJ?leg Continued/Additional Comments by SuperintendenUDesignate Commenle Signature Dale WW. 3 121% Mde?Ym? . mu 4 ilk. 20 mn?g Gun/It} lama-??l?M ij-Q 9?80.19 l? rtbwoao-r-a each?i :55 . ?3 l?F :95- AW M54052 mMreW??b?igcc? - ate. ider run.ch LCM-V - ?rm Hosp. I I Ell/m to .. - 4km Ji??e z; m: 3/97/51 Continued/Additional Comments 9y Regional Director/Designate Commenls Slgnalure Dale Dis Mhulion: Druginal Regional Direclor (Only (orRe-gbnaj Dmrar Review) Copy - lmmlu File cso 07'5-100 (10/04) 000357 i. .v (QED I I. I i . TV. MWBW 0? '43? Segregation Decision/Revrew and Correct one]; any (Sign: A, :l -I- . Kinetilqun I Central East Correctional Cenlr . . Name (Lasl. First. Middle) . - I ?w?Wmlion Nlo. I ?Reason(5) lor Segregation Dale of Segregation Protective Custody El Institution-Security Medicai Inmate Request 5 07 Aug 14 El Inmate advised of meson for segregalion Inmate advised oi opportunity to make met or written submissions Inmate advised of oppd?uniiy for interview with Superin'lendenl Inmate waives Oppodunily for inlg?ievr with Superintendent Name or SuperinlendenUDesignate (Print) Signature of Superintendent! a at Date Sgt. K. Stoffers 08 Aug 14 Sup enntendent (This section must be compieied within 5 days of the Inmate 's placement In segregation) Inmate Submisaion . QUINTE segregation l/M . I . I Sugerinlendent Decision Release from Segregalion _7 Continue Segregation Reasons: 7 .1 .. we.qu and Awweowv mcgwo gm eompum, ?3 W. . . . RIng ?1.41% mum-Ion); chokS?LruiLg Narne of SuperinlendenUDesignale (Print) Signalure of Su rin nil Esignete Date 44' . . i . ?lm/1% . - i - Segregallon REVIEW (Inmate's segregalion to be mwewed every 5 (gig. Interview with Inmate to be conducted every 30 days) inrnale Submission E?jocwv? 17b Superintendent Decision Release irom Segregation Continue Segregation 7' 1-. - I 4,47%; 7!:er - RBBSOHSI Name of Superintendent/Designate (Print) Slgnalure of SuperintendenUDesignate. Dale - - Y/l7/y? Supplementary Report for each Subsequent 30 Day Period (use reverse or form for additionarLommenrs) Comments Superintendent/Designath Signature Dale . 1 MMIddlm i 521(1) I i I CSD 075-100 (10104) I mm or 000358 14 23 a4 35 'Regional Director Review Conlinued S?gregalion Commenls Ci Supperied Page 2 El Nol Supported Name of Regional Director/Designate (Prim) Signature of Regional Direcll'JrIDesignale Dale i Supplementary Report for each Subsequent 30 Day Period ?e bottom of form for add iionai comments) Commenls A Signature: . Dale - ?33. . . . +0 i ?La (vi-w 032000053430 W. _.A0z We I . Sku?uec. 9?44: mime Era?f?fl?s "37mm M3 %f4fro kc. by Superintendent/Designale I Comments Signaluro' Dale I i . [at?paeo?rtjvib Marvin- 13/27/04 o?i/al/L?? V?'bfwilvmr 0 07003714 Raw?Has V13 A5 ?7 MM MM 0 ?7 Continued/Additional Comments by Regional DirectorlDesignate- Comments Signalurg Dale s.erR I 5. 1(1) s.21(2l(fi CSD 075-100 (10/94) Dislrihulion: Original - Req'onel Direclor (Only form-glans! Diradar Review) i Copy - lrImalo File 000359 13/31_ Page 2 ?gional DIreclorReView i Conllnued Segreggllon 7 Supported 1 Nb! Sggponad Commonls $0 . 2 - . . Owl Q?mlm+ in Ova Name at Reglonal Diredorloasignate Wm - Slgneturo 0! Regional Dkeclgioreglgnala Dale ??yawc Supplementary Report for each ?Subaaggenl 30 Day Parlad?se bottom ol'form commenls =33 Commenls I 0. Signature: ?Maum?cm-AJL - ofSiLOh?C?rxj??-Pdt??aa a .0. Lamwmw- avg/?ac nigh ?v . - ContinuedlAddlhonal Comments by Sumlntendemloesignale . Comments Slgnaturo' Dale: MMIchls?xim_?~ ?6 24 1m ?us/MW- a3 5 Mg KID CV- Oqiol/L?.3me Continued/AdJ?lonal Oommenls by Regional DireclOrlDeslgnale Date Comments Signature I MMIddm A w??m 5.21pm) Wann?mi??: ammo; (DwFG-m?ghnu Urqdarmdu) copy - Inmate Fl]! - - can 075-100 (mm) 000360 Regional Director Review Conlinued Seggaqalion - E- Commenls c) 13-? lom?u?D Supported Page 2 Nol Suppoded 05 per Name of Regional DireclorlDesIgnale (Prim) inc Signature ol Regional DireclorID'eslgnale Dale m/m/w Supplementary Report for each Subsequent 30 Day Period (use bollom of form for comments) . Commenls Signature Dule (?xv-?AI? 6/0 PM ml.in [Eh /o '07' lLl' I Contimed/AdditionalComments by Superintendent/Designate - Commenls Signalure' Date K?x [gaming-ow we . - mm Ll can. CL, - MW ?6 WVLL- i i 60 . . ?/Zalm AWWOKM mm?md? 07?. Continued/Additional Comments by Regional Director/Designer! CD Commenls Date Signature 521(1) 7 CSD 075-100 (10104) Origlnal - Regional Dlraclor (Only {or Regional Director Review) Copy - Inmach File 000361 Central East Co'rractlonal centre Inmate for 30 Day Segregation Reviews Inmate Name?; OTIS Nu-mbery submipsio'n er 30 day segregation review; )nmate Ural Submission for 30-?ay seregatlon? revlew: (To be completed by Segreation Manager) s.21(1) . Inmate signature: Date: October 6. 2014? WitnessName: A Wltness Signature: 000362 . - - a5? MiniSW ?Community Safety Segregation Decision/Review - o? and CorrectlonalServices .It Romano . We: may . institution i Central East Correctional Centre l?Name (Last. First. Middle) WW . Client identi?cation No. Reason(s) tor Segregation - Date of Segregation Sept 14 Protective Custody Security Medical inmate Request 1 . Inmate advised ot reason for segregation Inmate advised of opponunl'ily to make oral or written submissions Inmate advised of opportunity for interview with Superintendent - inmate vvalves Opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superinte lgnale Dale t. K. Stotters - 10 Sept 14 4' Superintendent Decision (This section must be completed within 5 days at the Inmate's placement in segregation} inmate Submission I - ilM displaying unusual and bizarre behaviour volatile and aggressive . i . Syneriniendenl Decision Release from Segregation it Continue Segregation Reasons: Barre- OMGL Ct?) NameoiSuperintendent/Designate (Print) I Signature of Superintendent/Designate I Date I I Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission . 1 i i Superintendent Decision Reieasetrom Segregation 5' Continue Segregation Reasons: - TLO - mack Aorist/Larval I . . i Name ofSuparinlendent/Designate (Print) Signature of SuperintendenUDesignale Date Supplementary Report for each Subsequent 30 Day Period (use reverse orrormroraddirronaiizommanrs) Comments Superintendent/Designate Signature Date - s.Nl fl s.14l2iidi 5.21 (1 5 CSD ore-100 (10/04) I . i 000363 Regional Director Review Page 2 Continued Segregation Supported Not Supper-13] Comments mid arc?Laubmiars-G?? b'emq uh. - Name of Regional Directorloesignate (Print) Signature of Regional Director/Designate Date . Em.? (or 10/ taco: I .l?i?7xi Supplementary Report for each Subsequent 30 Day-Period (use bottom ofform for additional comments) 4i Commenls Signature Date 3 . I /o/Comments by Superintendent/Designat?/ . . Comments Signature; Date . I (cog. i @?mcam Maw? gwluA/kmb Mk oq/zq/ret I I Vm J10 sit-W gA QAJA Aawdu - m/03?l4 #Ma??gww g4. [Aha-I?ka lo a. Luvs-7 " [tangug?-LRN: 'wx, ?Ln-?03- Vm Elite . Continued/Additional Comments by Regional Director/Designate - Comments Signature Date - . . Us.an MN I deLR? uoTJaoL? 4% gm, 94,403, . sum 3 i Distribuilom Original - Regional Director {Only for Realoncu manor Review) ?2 Copy - inmate Filo i . CSD 0T5-100 (10/04) 000364 954? I i I Centrai East Correctionei Cenire inmate Submission for 30 Day Segregation Reviews inmate Name: OTIS Number; Inmate written submission for 30 day segregation review: 0.94 ?g A - {in?ame-J 'AHjtz?z?/I521(1) Inmate Oral Submission for 30 day segregation review: (To be by Segregation Manager) afar'm-f" A Lea-K l/jiaec?s (emu/tn A?d ergo. a??14kg?jf;d?17 7m? 00?: 9M gums and). l/[giuffe b?imx?mv (10.1" was? on).ch ?r'o ourqu pvtaLJo-Xehbbu -D i 0 I Inmatesignaturei {Wo( - 3 Date; oSSJQU-l'ltf WitnessName: Srop??m . dam. Witness Signature: 000365 . 9? Ministry'of Community Safety 9 and Comgtignai Services INF). I. 37"? Ontario Segre ation Decision/Review Institution D) (3&0 t5"? ?eiee /4 42/ Central East Correctional Centre - Reason(s) for Segregation Name (Last. First. Middle) Protective Custody institution Securityr Medical inmate Request ,1 Client identi?cation No. Dale 0! Segregation 22 Jut 14 Inmate advised of reason for segregation inmate advised of opponunliy for Interview with Superintendent inmate advised of opportunin to make oral or Written submissions I . Inmate waives opportunin i interview with Superintendent Name oi SuperintendenUDesignale (Print) Signature oi Superinten De?te Date Sgt, K. Staffers 23 Jul 14 ?lb-?1 Superintendent Decision (This section must be completed within 5 days of the inmate's placement In segregation) Inmate Submission Pending misconduct for altercation on 2 pod Superintendent Decision Release from Segregation Continue Segregation Reasons; . - 2. '{Dt s. are mwkutg? '5 Am UL $-Lt '11- Name at SuperintendenUDesignale (Print) Dale Signature olSuperi Qavw\. Tsignale or .1 N- Segregation Review (inmate's segregation in be reviewed every 5 days. Interview with Inmate to be conducted evety 30 days) Inmate Submission 7 Vt?? f3 *9 7? 1 LN LAW Superintendent Decision I Release from Segregation Con El iinue Segregation . Reasons: 'Now- cuseoce. La be, vaw Name at SuperintendentlDesignale (Print) M- to?\ I Signature elm/Del i stgnete Date Supplementary Report for each Subsequent 30 Day_Period (usereveme offonn for additioneiteommenly Comments SuperintendenUDesignate Signature Date $.L4t2itdi s.21 (1 . . - 030 075-100 0104) 000366 i?B- as Regional, Director Review Page 2 Coniinued Segregalion Supported Not Supporied Commenls Name of Regional DirecliJrID?signale (Prim) Signauire of Regionai Dimmer/Designate Dale 0 SupplementaryReport for each Subsequenl 30 Day Period {use?t1ng of form Maddllional comments I . Commenis - ?gnhluro: Dale Comments by? S?perinte'ndenUDasignate i Comments Signalure: Dale - i m$$og VLUW ?Jr c4464., 'l 7 04* ?Hr-Hic? ?Im Hash-$0 %m.M hue-36" 04? os/Dg/?qv mm Mail?s) . p? a 31?? 5-45.) Lung-5 Q. . In I (RAVI-4M "a-D Hon?'tmq?iatf .7 . i a ez? mm 2343-5 on? \13 - ma . in. (Fauna-mark maxi-L) and (An-ng i ?4 Continued/AddilIOnal Comments by Regional Director/Designaie - Commenls . Signalum? Daie cso? 075-100 (10/04) s.21(1) DISlribullon: Original Regional Diraclor (Only Ior Regional War Review) Copy - Inn-ale Flia 000367 2?5 v? Reqional Director Review 5 I Page 2 ninu'ad 39 re allon Earn ?90 A.an Narno of Regional Dire-ciotmlonatetprinl) . Supponed I NM Suppoan . Signalure lgnale - I Dale I 49.6w? ??oq?koly en on (or ?ach Subs ES Comments ConlinuadIAddiliohal Comments by SuEerlnlendenUDesignme 30 Period of form additional cornmeal Signaiuro'. 1 Dale 3.44% Hum-M?Iuc. Vdrq??m 5" LHQL, MN Mu. c. - nAAtfrx'iDQ'. ?lm m. .L 55> b1 08'] Aha-\Jana?aw-Id wadn? WT ?b?w?u \h VI W?k Conllnu'edlAd?'LonaI Commenls by RegionalDirectoWDesIgnale - Commanla Signalme Dale nun?l? oso Io-raaoo (1 0104) chmbullom Onoilal magma] DUWIOJHUF-ugbnawfmd - Copy-mu Fin ?me .. 000368 Regional Director Review Page 2 Continued Segregation Supponed Cl Not Supported Comments Name ofRegional Director/Designate (Print) - Slgnatura of Regional DIractoriDesignate Dale Comments Report for each Subsequent 30 Day Period (use bottom of form foir additional cOmments) Date MIdeiwz {?y-alum I f, i4?7( I of/ZZ/Z?/i lionlin'uedlAdditional Comments by Superintendent/Designate I Comments Si'nalure' Date - A - I INK pr?HnI-w? In rnVa??ta +73 0-. - ?7 try/moi; WI WM. . 7/37/45. lH:- iota NW 91?" Mm?m 0.4. (finial/?74; Ago-Ah? I I .mqh- - W?rh Oh cl-ZL 0? Nil (ct?Q I Continued/Additional Comments by Regional Director/Desi?le Commenls Sanature' I Dale 5' 5721(1) CSD 075?100 (10/04) lrlpuuon: Original - Regional Director (Only for Regional 011-ch Ra'vievr) Coay - Inmate File 000369- a Page 2 Regional Director Review I - Continued Segregation .Ei Supported El Nol'supponed Commenlsaa - II - Wmeeok ?Qccl/Mo)? DCW inm4~r I He mom}. Se?mm?km. Nameof Regional Director/Designate (Print) Signature of Regional DirectorIDesignate Date Gm 342* who: 422530.40 Supplementary Report for each Subsequent .30 Day Period (use bottom of form for additional comments) Comments I Signature Date MdeImy more. Audw . . I/Q/ag/mfi I 0 ContinuedIAdditional Comments by SuperintendenUDesignate Comments Signature . Date - \6 (I - MMIddImyr MAL-PM o- LumiA WW- . 3 q/Z?//Lf VH5 Ll: - (la-N ?x A I I I 10/0 3/14 I ?m I to] Felix-? A?s-Mf- A - I . CAM-I /m 5. WI - ?tamtmol I - I Continued/Additional Comments by Regional Director/Designate Comments - Signature Date I S.NIR I 5.41( I i 21 l2llf) Regional Director {Onry lat Regbna) Director Review) Copy - inmate File CSD 000370 . I .. w. .1 ?(immunity Safely Segregation Decision/Review and CorrectionaLlsegrvices a; l, Ontario Ma?a-W0; . Institution ,1 . 5471/ Central East Correctional Centre Name (Last. First, Middle) Client Identi?cation o. Reason(s) for Segregation . . I 7 . Date oi Segregation Protective Custody El Institution Seou?ty Medical Inmate Request 14 Jun 14 Inmate advised 0! reason tor'segregatlon Inmate advised of opponunity to make oral or written submissions Inmate advised oi opportunity ior interview Superintendent Inmate waives opportunin ior Interview with Superintendent Name oi SuperintendenUDesignate (Print) I Signature of Superl [9 if I ignate Date K. Staffers . a. . 06/14/2014 Superintendent Decision [This section must be completed within 5 days of the Inmate?s placement In segregation) Inmate Submission 1 Admitted to segregation from - suicide watch Superintendent Decision Release from Segregation Continue Segregation Reasons: 2N. ALB knew? MA 30.3uuf.lq Name of SuperintendeniiDesignate (Print) Signature of Superi nUDesIgnate Date - FL . Obliqil?' Segregation Review (Inmate's segregation in be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate-Submission i -. LSuperintendenl Decision Release from Segregation . CI Continue Segregation - - Reasons: (3 13?? 2:3 I TemuAh? chr? ?3ng WertrL~ 24?) - Chit?0? 8% +194- .cchg.? . I Name of SuperintendenUDeaIgnaie (Print) Signature of Sup - rinle o. II 'nate Date S'c-rr- .. Supplementary Report for each Subsequent 30 Day Period (use reverse arrorm tar additiona'tbamments) Comments SuperintendenUDeaignate Signature Date I 'i - I sen(1; . sa21(2Xf) I i C50 075-100 (10/04) I I 000371 i I Page 2 Regional DireclOr Review i Continued Segregation Sygported N'ot Supported Comments i - . . Name of Regional DIrecIorIDeslgnale (Print) Signature'of Regional Director/Designate Date 1 7 - A Sugpjomenlaa/ won for each Subg?uept 39 Day Perioiarse ppllom of form foraWal?mls Comments Sig 26/ ,r ,1 new ?41? 4? . I r/ Continued/Additional Comments by SLLperintendenllDesignate - Comments . I I SignatureI ?fm to?-Hnruj; I ob/zq/I?It' run/81x1 c?L I I $0 M420 ?44,130?sz 07/61311/[76 . - @Wadii ftMM?c?m c? . l. a I 7mg?? 7/ HTML await-mot '1 AA Foxtron (?lm ?44?.Mute/va? Akron?Arc, 0L . i I I \[Mc'hQ mmksadm cubkoheA?ka . COntlnued/Addilional Comments by Regional Director/Designat Commenls Signalure? . Data . - T:th Eugen??- I I Wi? s.21(1) I 5 I Dlaldbullon: - Regional Director (Only IorRoglonal Nectar Review) Copy - Inmate Fllo I I CSD 075-100 (10104) 000372 Page 2 - ?egional'DirectorReview . - Continued Segregallon Supported Nolat?lpponed \lb- auLmJova? - i OmcLl-V Tea-?um f?1chLo3~? I Name . I Dale - ?lm/wed? Su lament foreach Sub ue mo 03 Period use (10m afform fora Inr? ls Comm-fitContinued/Addilional Comments b!'SugerlnlendenvDeslgnate i Comments Signaturu: Data . MdeMyyr lg. EALMK 5 09/5/15? 20 0 mm)? a?f?g? m% a. Era. - 07/4/1510 as. 30 Wngm?cgtg?g "Jimi?a fl?? and ?Mg gmg??i?g?mdbows 311W . 4:4 Rw?t?" ?Inn?Ho ?Mun i . . I I - k4. Qumwlk". i . . I wm??.u ?J3ka . gm '7 D7/I'7/llf ContinuedlAddition?ommean by Regional Director/Desiggle Commanta Signature: I. - Dale - i STNIK 321(1) c. 91(9)(f) DIIMNIEM Origirwl Riv-aloha! Duaclor Dinner . can 07540:) (10/04) 000373 i . ,x as" i Centre! East Correctional Centre inmate Submission for 30 Day Segregation Reviews. inmate Nam-e; OTIS Number: inmate written submission for 30 day segregation review: \j 1*13 'aALAalhaer3?k - - .5 ?gkbm ymzk. I 521(1) inmate Oral Submission for 30 segregation review: (To be completed by Segregation Manager) inmate signature: . Date: i'i-i - Witness Name: S?m came? Witness Signature: 000374 '54 51 I . ?agional Director Review Con?nued Segrega?on E3 Suppoded - Page 2 7 NetSupponed Comments Name of Regionai DIrecIorlDesignala (Print) Signature of Regional DireciprlDeslgnale Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments [Kg Commems mgnature. Dale 0 woo;? (refit/W mm . (MEG. d'bg I I and: . oit??m Continued/Additional Comments by SuperintendenUDeslgnate mulch Comments Signalure' Dale .. WKQM j?mlh xx Lu? Viv-lie; ?/zg/lnf PWEQL h: Joumo?im (TLGL .14;ij M- or \Im In unp?=ak3lc??ubb BeMdowd ??qu?xe?oau 0 51031be 7/1? I. 6 . Works?bimw": JD ?Sufo dasm'ob._ bun harm, av? . - Habad?2-. . ContinuedIAddilional Commente by Regional Director/Designate Commenfs Slgnalure' Dale fouled M?gliq .- I 521(1) . . . - DIaI?Dullon: - Regional Dlroclor (Only for Regional Drcdar Revlaw) Copy - lnmala Flia cso 075-100 (10/04) 000375 Central East Correctional Centre [Inmate Submission for 30 Day Segregation Reviews inmate Name: OTIS Number: inmate submission for 30 day segregatlon' review: I Wan/(Leaf Inmate OraIVSubmisslon for 30 day segregation review: (To be completed by Segregation Manager) Inmate signature: Witness Name: - Sheena McWhinnie Witness Signature: Date: Auqut 1Q. 2014 000376 ?egio?al Director Review PageZ Continued SeqreqatiOn Supported [3 N01 Supnoned Comments 60 SI 9 a Hog Inmaicm -UrxoLer Chimth Name ar'ReglonaI Director/Daslgnate (Print) -erc( ?ne; Signawre of Regional Director?) ignate DMO ?fLo/r additional comments) Supplementary Report for each Subsequent 30 Day Period (use bottom of form Commants gnnlure Dale ?02 . - . 'wd?cm . I i . - MWLWEW aw?; Ore-.12 as ga/M/Zgr/ continued/Addhional Comments by Superintendent/Designate Commems Signalure Dale I - MdeM ?lm WE soc/w- ?9'1 I an a. - Ii ?7/257/4- Lima-50L +0 ?ab-?494% Wot/(4 \lm Lin-q a9: - \?qu SekuakgL 0 3/03/44; ?lm I . Mw-Lm?wgg . or 031131"/? mew, mm. bu? ?arm. or I Inga?. A gluljhp WW. Mth?umw? . . 2? Contland/Addi?onal Comments by Regional Director/Deslgnate - Comments SignalW Dale - s.21(1) 5.4u4u) v? I nimbu?nn: ow - bleak-ml 9km (buymnegbw nut-ado, Review} copy - bum: File 050 076-100 (10104, 000377 I I I 2 . Regional Director Review Continued Supported Not Supported I Comments Name of Reglonal DirectorIDesignate (Print) Signature of Regional DirectorlDesignala Dale 1' Supplementary Report for each Subsequent 30 Day Period (use bottom of form for comments) . Comm-ems if, Signature 0.0 .[eutmt .- owe/2W . Continued/Additional Comments by Superintendent/Designate Comments . Signature . Dale ?30 . Univ-laws ken?skew - a 0. we 40.0.34 - Zia/?1L . 1? too-Ptm041 owe? b?t/oIJ/t/?f ?I't '0 . i tut-?cube/ma . . . I I 36' Q?mrh-KM If? ii :43 Continued/Additional Comments by Regional Director/Designate? - Comments - Signature Date *0 . . -- . 3m Ba'meiawm ?ob-ma- - i ksm?\71. {Meat I $293.09- A?uu?xs??k who. kmuecxewtd?x. o?illb/I?f 7 IID Distribution: On'gtnal - Regions! Director {On-y for Regional Director Review) .I F13 . . 521(1) 080 075-100 (10/04) - 000378 Page 2 R?gional Director'Review Continued Segregation SUpponed No! Supported Comments I I 313'? C??c onh?ahm?g I I I Name of Reglonal DImclorfDeslgnale? (Pn'nl) Signature of Regional Mentor/Designate Dale fw?a?x cape/610,175 Supglementary Report for each Subsequent 30 Day Perlodfusa bon?om afform comments . . Comments . .Signawre Dala? - I 1/7" cam/2m Continued/Additional Comments by Superintendent/Designate Comments Signature Date A MWUUW [Aqu I 9W I .thow?m+?J?b - .2 ?Imkm-kws ?wk earl Mar? I rayon/M. - LUM- Z- - .1 Al .5..th MW - I oi/bg/V?p A?"m Continued/Acidi?cnal Comments lay-Regional Director/Designate . - I . Commenls Slgnaluro'..w\ - Dale I B: *k?m??a?dgok' mnu? la . whacked? wo?.?wm t: 91(1) DIMDWN: Orighd - Re?b?l] [0'1ny W1 MVP-9W Cur limlo 650 075-100 (10:04) 000379 Regional Director Revie 95 on 1.231% beLm?taurt Continued Segregation Supported Not Supported Page 2 Comments 1 9?043): Am gee th L, Name 0! Regional DlrectorIDestgnate (Pn?nt) ?aw Aug Signature of Ra'glonal Director/Designate Data 10/ Zak/2.0156 each Subsequent 30 Day Period (use bottom of form fo'r additional comments) Supplementary Report for . Comments 1 Sin; nature Date 2% /0/?lo Continued/Additional Comments by SuperintendenUDesignate Comments Slgnature? Data i Ukwswog <5 5%va e. bakow't com: 7 o?ui'u?r?x ~11 (Qcmm\wxw\3.? 16g ON '7norm 105 ?do Unwed I bghgacgmr . "w - \rc' Ukusuag 0? \ai?uw 4e. Bahuxo?uw .- mm: o?z?i) 1i 0' 46% engine-xix; WA 1 oar/30! [4 I Wk; iggw km? Nab; (25:51 5513.23.93 Ikim-irva. 263 to]! 14 Mm?ev-N ~r (.mmhhArN-Ib - i .I . Continued/Additional Comments by Regional Director/Designate I . Comments Signature? Date 1 i Agar/tau: m. Ma 5 r' a9) JAMMDJ \J?ILq-tie. \oeA-?a-?AoU-V-- QWWN A Dlatrtbutlon: Ongmal, Regional Director . . Copy - Inmate Filo I A CSD 075-100 (10/04) I 521(1) I 000380 Ministry of Community Safety and Correctional Services we? Di? Ontario Segregation Decision/Review in stilution jitte- rjo? in? ear i Central East Corieciionel Centre Name (Lest. First. Middle) 175 i (you Client identi?cation No. Reasonts) for Segregation Protective Custody lnstitutlon Security Medical Inmate ReQUesl Date of Segregation 17 Sept 14 Inmate advised of reason for segregation Inmate advised oi opportunity for Interview with Superintendent Inmate advised of opportunity to make oral or Written submissions Inmate waives opportunity ior tnlervlew with Superintendent SMLUQi-Kzuuref A Name of SuperintendenUDesignale (Print) Signature of Su rt UDeetgnale Date . Sgt. K. Stofters 20 Sept 14 Superintendent Decision (T his section must be completed within 5 dayigf the inmate?s placement in segregation) Inmate Submission t/M requested segregation (RAC Sept.9) i Superintendent Decision Release lrom Segregation DE Continue Segregation Reasons: via/moi: ?i'b vlfotmxotxm'b 67H intact/b vL-L/rupi? Name of SuperintendenUDesignate (Print) Signature oi Superintendent/Designate Dale Inmate Submission Segregation Review (inmate?s segregation in be reviewed every 5 days. interview with inmate to be conducted ovary 30 days) #Superinlendent Decision El Release from Segregation Reasons: Ag.ka WW Continue Segregation Ox i Name oi SuperintendenUDesignate (Print) Signature of SuperintendenUDesignato m/gl; Date were, Supplementary Report for each Subsequent 30 Day Period (use mvarsa oflonn Ioraddruonarizommenrs) Comments Wow/4 SuperintendenUDesignale Signature . Pate - 030 0754i 00 (10/04) 000381 i Page 2 . FRe?onal Director Review 1 Conlinued S_egregallon Sugporled . Not Supported Comments 30 I . a? ?ea? Cf} 30 meme?am. 'Hm. :erci Name of Regional DIreclor/Daslgnale (Print) Signalure of Regional DirectorlDesignale Dale ?giaq?uq Ice/2542mm Supplementary Regorl for each Subsequent 30 Day. Period (use bottom of form for addl'flonal oommenls Commenle Signalure l: Dale antinued/Addilional Comments by Commenls Signalure Dale MMId?mr LbnoJoLz +0 ?mt/1.me o-h QNggAIo-x? '5 ;?-l-flu?q a I 1.0 '02" ?1 Wale/Leia an GLM 5 . at) I 3/44.? 3? ?ran [o'lgv'q I I I 3" um?auaghokaajtaf'v - II Continued/Additional Commenls Mammal Director/Designate Commenls Sig nalure: Data 1492931 521(1) . 5.2mm) Onginal - Rommel Diredlor {Only for Regional Diredor Review) Copy 7 lnrnalaflle 7 r; (:30 075-100 (10/04; 000382 Ci?" 7 n' Ontario Ministry of Community Safety . and CorrectionaLServices :rmr?ifa DU st" Segregation Decis ion/Review institution Central East Correctional Centre i ajS?tO siLi-ts' i. Name (Last. First. Middle) - Client identi?cation No. Reason(s) for Segregation Protective CustodL institution Security Medical Inmate Request Date of Segregation 03/18/14 inmate advised of reason for segregation inmate advised of Opportuntiy for interview with Superintendent a inmate advised of oppodunily to make oral or written submissions inmate waives opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Sheena McWhinnie Signature oi SuperintendanUDesignata Date 03/18/14 Superintendent Decision (This section must be completed within 5 days of the inmate 's placement in segregation) Inmate Submission CECC than be transferred to another institution States he is 0K in segregation and he understands the reasons that he is placed in segregation. He would rather stay at Superintendent Decision Release from Segregation IZI Continue Segregation Reasons: Subject escaped custody while on 'a medical TAP and has assaulted start 'on 4 separate occasions at CECC. He is currently being housed at CECC because he has court in Lindsay on a regular basis at this time. Name of SuperintendentIDesignate (Print) 8. McWhinnie Signature oi SuperiEtendenUDesignate Dale 03/23/14 Sewation Review (inmate?s segregation to be reviewed every 5 days; interview with inmate to be conducted every 30 days) inmate Submission not ha? ha c,ch Ci Release from Segregation Superintendent Decision Continue Segregation Reasons: for: 2 - haw/Lad 10.4 40 L's?i171, Acme/WW 5m MW . *7 1556244261735 ?iufg (1 Name of Superintendent/Defignate (Print) Signature of Superintendent/Designate Dale 8 I 8m 5 3/29/14 1 I . Supplementary Report for each Subsequent 30 Day Period (use reverse or form for additionai'oommenis) - Comments SuperintendenUUesignate Signature Date s.NlR 91(1} (:50 075-100 (10/04) 000383 :1 l5 815 .1. Regional Director Review Continued Segregation El Supported Page 2 Not Suoported Comments Name of Regional Director/Designate (Print) Signature of Regional DireotorIDesignaie Date I Supplementary Report for each Subsequent 30 Day Period (use bottom offor?MA?r?onel comments) . . Comments gna re Dale I in ?Pwa-? 14M 0 $95 l7- HM Continued/Additional Comments bLSuperlntendentlDesignate Signature Date Comments dz caca- v94 c.0494 Low?haeL .4 'jaJLugg' I um 3. ?1 Li New oath-545 4-ai CECC. LH I (24.1?11.6 eel SmaD/wunlry 4/ lei/1+ 5:6 ?wo re?t?255C? Siliqu Li "to WMHB ?cc? Conin- W01) ?Adding ?9 9% a} r490; "Wag/ht ?ll/ML- 43 mad?g ceo; CA,qu e/LL/hl Continued/Additional Comments by Regional Director/Designate Comments Signature I Dale 521(1) Original - Regional Director {Only for Regional Directormvlew) t; Copy - Inmate File CSD 075-100 (10104} 000384 I Reqional Director Review Conllnued Segregation El Comments I Supported Ci Not Supported Page 2 7; Name of Regional DiractorlDesignate (Print) Signature of Regional DlrectorlDesignate Date Supplementary Report for each Subsequent 30 Day Period (tree bettom of form Wm I comments Comments Date CBC 45MB 44in . . [Al-94 3% tat/3 - .r ContinuedIAdditional Comments by SUperintendenUDesiJg?te Comments Signature Date Elia/[cf _4 4,0 mm cf 3 W?igt mW Lushhf-w'? Mgml?q tf??mmw, zit-mt: at IK Um mam K3 4120?;? afaouj C??oa W71 [55ICE- +0151 (Li CEJCC. ci- (ti/$7047: lLiN?thf 33h: am ?5qu . I I #6 i??hthMumCt- 5197,54 mm 05cc, 6% 7S 4?:3 800mm E/Ollti ContinUedIAdditionat Comments by Regional Director/Desi nate - - Comments - Stgnature_ - Date 521(1) I Dlal?hutlon: Original - Regional Director (Only turneng Dr'de Review) Copy - inmate Ftta 080 075-100 (10104) - 000385 Page 2 Re?iona? Difeclor Review A ?agelion Suppo?ea . CT NotSupporied #3 Fer 7800mm a?ILca?i wa OULMWK Mo/ 0 (?Wax Name of Regional Diraqorloesignalo (anl) Signature 01 Regional DiraclorlDesignaie I DaIe - Sup?emenlag Report for each Subsequent 30 DaLEeriod (Use bot?ng ofrom?ffg?aBidljg?cgmments - Commonls om ?55172; .144 wrte I MW -5 am EC - Wdumt?' .0me3?: - n. m?sgpm ConlanedlAddltional Comments by sagr'intendenuoesignale . Commanls - Signature - Dale h4deer {Shy/4 .3 - mm (293a W44 "+oucCM-9' 1" 400-4; .i 55m ma 35?an +0 41?ch when} 0017? - Mwuw MM ?dusi-WT'EW - . Emmamhj WU. 935mm Vin a. . FA 7 - [mis?le can 7i WW Wot/? ContinuedIAdditlonal Comments by Regional Director/Des nate Comments Signalum . Dale I ?Z1??ff cosy-Imam CSO 075-100 (10104) 000386 Regionel Director Review Page? 4- Conlinued Sigregalion Supported Not Supported Comments - Name of Regional DirectorlDesignale Slgnalura of Regionat Director/Designate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form for addition?ef comments Comments mature Data m?f?TW q? 3%:qu .J 1% 25/203: met. .7. ConttnUedlAdditional Comments by Superintendent/Designate mm? Comments . Signature- Date Mde/ygm Shaw/W z/xr/ 6.. >714 . Q5 .[klea om . ?zz/1% 'Adm . ?5 alum. 614M I . at? 4.110%. 4.413% ?Catt?J 09/25/ka _ContinUed/Addilional by Regional DirectorlDesignate Comments Signature - Date .. MMIdd/ym S.NIK 321(1) 1: 9119"? - Dlautbullon: cso 075-100(10104) Original - Regina! Dicedov (duty for Regional Diredor Hamish) Copy - Inmaln ila 000387 . Regional Director Review Continued Segregation A . aupponea Not Supported PageiZ 4? Comments 3961 84-0945an Glut?R- 2L7. 9a- luv-wk ?g?c?m I 9' cmmeT?P-r cam-tht augmhalm mew-1.: man?I1 mea?- Co dud: Name of Regional DiredorlDaslgnale (Pdnl) Sign?ure of Ro?onal DlredorIDesignale Date 5% Q1 4.4 a7 (as/20:9 Suapnementary Regort for each Subsequant 30 Day Period (use bo?orn of comments I ,1 1% 66/24/24; If}: 'Con?nued/Additional Comments by Supe??andent/Deslgnate (af?x/mt Gammonls S?ture Date I. - Mde/yywr ?30 aqomeg Cv/g/I??t 0445/4 Continued/Addiliqnal Comment?y egional Director/Designate Conunems Signature Dale - 82112)?) 075.100 (form) Dina-lbuuon: Onglnal - logical Dim-n: {Ora Firm?55'an Wade! Review) Copy - Irma: Fae 000388 _/00 #26 no 190 jegionaiDirector Review Continued Segregation Supported Page 2 Comments Not Supported Name of Raglanel DirectorlDesignala (Print) Signature of Regional Director/Designate Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional commep? Signature Comments 9 07, 454/} Continued/Additional Comments by Superintendent/Designate Comments Signature Date 7m 4'0 Warns-4h in 9 aim +0 Pas-f ass"; oauth? banm?guv Qli?g- (L. g8 . m- o-rl/og/w-f mm Mam.m? .49? . Iozm/woow Gooamg. 5 ?Us; 5.747% I C3560 ol? mtg/(0144 J4 Mae [rm ?/n1 4v Mail/vv .. Mc?o-L (an AM Aman qu 0'7/1wlq \H?sm? . I d3?. *9 135.; AMMHW 2/2 ?32 Wmu? I lb?l'iln'll?i . Comments bj Regional Director/Designate . Comments Sig nature Data MMIdd/ym 12900.4 L48 45.21am) Distribution: Original - Regional Director (Only for Regional Director Rarity) COpy - Inmate Ila cso 075-100 (10104) 000389 . 'egibh?! Direigbi- k?vfew Continued Seqregallon Supponed Page 2 CdmmEhlS I Q.- Name of Regio??l Diradormealgnale (Prim) Nol Supported Tun-90M, ?De. "th a 630$ ?aw; ?73.79; Signalure of Reglonal DIrecIonfDeannEw . Dale fwll?zm? Sumnlermennagr Repon for each Subsequent 30 Day Period {use attain of form for additional commaplg/r/ Commonl; Signature CondnuedlAddiliohal Com rnenls by SuperintendenUDesignale Commanls Slynalure Dada - - dedlm'yl - 7m 49 Vf'rmCl-ln :n 9' chau? . Par-o, . _/00 95.; m: Law-e; ?Mb 66/977crying/I4 ut/vw L4 aqua?? as at (2.94541:; m?wu ?Ian?d - M5304.- )4 I 'n 1 1mm ?Jam AA. D'II/la/lq? Vm Wax: $2 I 501350011060 ?4t1.} I A - ContinuedlAddmonal Commenls by Regional Director/Designate . Commenln Signalure Dale _MMIdder s.21(1) Dixmbulion: On?o?rwl - nonan (any I'd/Regina! Mew Rm.cm Cw; lnmala FUD can. 975-100(10104) 000390 central] East Correctional] Centre inmate Sabmisslon for 30 Day Segregation Reviews Inmate Name:_ OTIS Number: Inmate written submission for 30 day segregation review: A DECLQ 1mo?0U' inmate OraiSubmission for 30 day segregation review: . (To be completedb Segregation Manager) I a 3W4 L443 Ina/761 gawme 0e wig; 0L -0 (430de Inmate signaturei ?7 Date: Auqust 16, 2014 Witness Name: Sheena Witness Signature: 000391 i Page2 Regional Director Review Continued Segregation ouppcuned 'Not Supported Comments Name of Regional QirectoriDeslgnale (Prini) Signature oi Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period (Use bottom of fogm for additional comments Comments A inature Date . . Mde/yyvy 1?50 nm gm Ei'o MW arm? do? - DIP-CW uni-i . a; 06/14/2677} Continued/Additional Comments by Superintendent/Designate -r . . Comments Signature: I Date . . . 1.95 Mai-M.) 4 A ?lm/M 'T?bf?m - . - iBl cal; +5ij Wad/?amzzg oi?sec. . 57k - 07/1814 I 4t!? I 1% wk +512, 17 I A13 52c, 'T-Lam?m deovL-?- - PLM I Um Q. take,? ?gmemmgq WW I QAQQECL .lmwr?o, we W. I. +2.0 cm I Continued/Additio ai Comments by Regional Director/Designate Comments Signature? - Date -. xToweoLU/kwaw?lihi will?!?i I s14(2)(dl 521(1) Distribution: Original - Regional Director (Only for Regional Di'redor Review) 7 Copy - inmate File CSD 075-100 (10/06) 000392 .. Regional Director Review Page 2 Ccminued Seg?ga?on Supported El Not Supoorted ?mmenrs Jfgo t3L?: er Name 0! Regional Dlre clorIDeslgnale (Pn?nl) Signature of Regional DiredorlDesignale Daie a? I j/Zo/?r (inn-1* HQ I . . I Suppiementanr Report for each Subsequent 30 Day Pen'od (use bottom of form for addmonal comments) Commenla nf I Ignalure Dam {?50 - Mldewa I ?'omm? ,4 W.WR rm: ssium- . 06/14/207? WM Continued/Addldonal Comments by Superintendent/Designate W4 Comments - Signature - Mwagilgmr I Hi ova?EA? I :7 MM Id:9 . o?u 9: 07/22/14 - - - 5[ 4 CC. 37%. *1?wa o. 'm-?nz ?a . . \K?o?ibob Ll gm lav?u 1-6- .. .L ?on-3 a 6 ?n A (Lace. i . 'lmMArkaM LAM- - ?le/15L; Continued/Addi?o?al Comments by Riggm Director/Designate . Comments. Signature? I 0310 I 344mm? s.21(1) Dist-Ewan; O?oln?- Regional ohm (Only :og-?w Worm ?In (:50 075-100 (mica) 000393 Page 2 Regional Director Reviev. Conlinued Segregalion Supponed . Not Supported Commenls . Name of Regional DireclorlDesignale (Prinl) Signature 0! Regional DireclorlDasignate Dale Supplementary Report for each Subsequent 30 Day Peried (use bollom of form for addilional Comments Comments . Signature. Dale )7 Mde/vm ND. 1 ?591,206 A 14? COntinUedIAddiIional Comments by SuperinlendenUDesignate I Commenls Signa?? Emma-?Wynn -- 0mm M00 R?bxm?n?A-s *0 A-EMW v1. :aj rm}; ?g W;?Q?iw ELM . are haw?.- Aramwo Dq/Ogn/H? 9m - ?45 '(ngm??xrg MG m-L- I c.4011 ?rub "oql/?Ie/ML Continued/Additional Comments by Regional Director/Designate Comments I Signalure? Dale - S.NIR DisII-ibullon: 4? Copy - inmate File - - s.21(1) CSD 0?5-100 (10104) . 000394 Page 2 Regional Director Review Continued Segregation Supported No! Supyorled 0356541 ?06 Sakai/?55 . m?w ?LL?wk t~?qdio~?r Name of Regional DiremorfDualB??mn (Fun!) A signature at Regional Director/Designate ?Date Gum gm? calm/acts; . . Sugplementery Report for each Subsequent 30 Day Pen?od (use bottom of form foradditianal comments) - Tomi-name Signature Date /1 - - off/MW Continued/Additional Comments by Supe?niendentlDesignate Comments Signature: wgate . . -7 Mr cur-u Mug- La I . 7 15L beak?rs wag/K4 - . nun..- towel" n?N Ln. up 73 lain?r; on: I a I P36 Lanai} gm??i (I ?ewe-av?) We. oq/tc?r/l $3 ax. AA-Mkk-MmmAf? the wand. Oqli?n/Iy? Continued/Additional Comments by Regional Director/Designate Comments Signature 03m MMIAQQM 521(1) Olih'l?buuon: mom - neutral Drona: my mum: Dow - Imulo Fae A CSD 075-100 (WIN) 000395 Rmnal Director Review . Supported ConlinuedSegrggalion Page 2 Supported Commentsalo ulna Mtg?a? comb?- WM40A49MMW 51 0mm (We? Aver-Agu? r?wrw-Jh- ?Goa unlit"K a?em?. Ea ?I?Lu-ch .- Name of Regional Director/Deslgnale (Print) bQ-H-?n? Signalura ol R?gional @0551 DIraclortDesignale Dale 10/294101? Comments . I I Supglementa'ry Report each Subsequent 30 Day Period (use bottom of form fo'r additional comments) Slgnalure Dale MIde/my .500 gamma?; 51.2. mg, ?gs-g 12,: age M45301) M510 I Continued/Additional Commenls by Superintendent/Desigate Comments I I Dale ts< pct?1.3: oasgu??a 431wle d. I i MWM whim ?M?oa~w ?utmmhe. 0L. ,wb 0.4 4050.} saw-L 0 oq/M/W ?Log :13 1 09/25/13? @dm?W?-M m0. Lo pack ?2 an (1ch zoo mm?M-w ?Loam-m kg. . .o/ogm I . t? I I 90% (Ream-'t-M-WN Continued/Additional Colis by Regional Director/Designate Commen 5 Si. naiura? Da I . 7 3v)? Ow L14: @5314 towel?; ?mm I s.21(1) cso 075-100 (10/04) DISlribullnn'.? Original - ?agtunal Dinner {Only for Regtmat Director Rovicw) Copy - Inmala File 000396 I .i ?f9?mmumi? Safety Segregation Demeton/Rewew and Correctional Services p- I 7 - ntarto - p! ?it? 179? i . . i in". a. I It lien Ll netu I OED 54 Central East Correctional Centre Name (Last. First. Middle) I Client identi?cation No. Reasonts) tor SegregatiOn Data at Segregation 8 Protective Custody Institution Security Medical Inmate Request 11 Sept 14 Inmate advised of reason tor segregation - inmate advised ot opportunity to make oral or written submissions inmate advised of opportunity for interview with Superintendent Inmate waives opportunity ior interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintnate Dale Sgt. K. Stofiers 16 Sept 14 . Decision (This section must be completed within 5 days of the inmate?s placement in segregation) inmate Submission IIM admitted due to bizarre and unusual behaviour. - i SUperinlendent Decision . CI Release from Segregation Continue Segreqalion Reasons: +3 L176 4., Name otSuperintendenliDesignale (Print) I . Signature otSuperintendenh?Deslgnate Date (gt/(toOttiuutE/ 9- elm/let Segregation Review segregation to be reviewed every 5 days. Interview with initiate to be conducted every 30 days} inmate Submission h3uperinl?ndeni Decision [3 Release from segregation Continue Segregation - I 5 Reason?? V1.0 Name at SuperintendenUDesignalev (Print) . Signature of Superintendenupeslgnate Date SMth-wm e; ?i/zC/M Supplementary Report for each Subsequent 30 Day Period (use reverse at form for additional comments) Comments . SuperintendenUDeeignate Signature Date . - s.21(1 050 075-100 (10104) i - 000397 i5 675 Regional Director Review Page 2 Continued Segregation . Supported El NoiSuppmted Comments UnakkAw Name at Regional Director/Designate (Print) Slgnature of Regionel Director/Deslgnata Date gc?Z?r?-?NK .7 lo/ZqianSC Sugplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments - Signature? Date A i MMIddImy /0 Continued/Additional Comments by Sur?imendeanesignate Comments Signalu re Dale La +0 L. at I leab . ma. 341d.? ?Hunt? [0.01.14 mama-A9344? O?f?u/mb W??a?e Mark/5,2] Jo/Jali?f \ow?um?ow'f . \M?ng 0* RRx/?ionw 53 Io/Hj/?r? um?wkm in: chat mag with. Wmu? - om airsCo?tinuedlAdditionai Comments_by Regional Director/Designate . . - Comments Signature Date i 5.21m Distribution: Originai Regional Diracmr row): for Regional Dir-odor Review) Copy - Inmate File 075-100 (10/04) I i 000398 M?ms?? Safety Segregation liiecision/Review?a PF DROntarlo a?dc?TE2it??2lEi?705.23? inst in [on 2 I 1 Central East Correctional Centre Name (Last. First. Middle) - I Client Identi?cation No- I. ??uhUKi\Date Of Segregation Protective Custody Institution Securily Medical inmate Request 19 sept 14 inmate advised of reason for segregation Inmate advised of opponunlly to make oral or written submissions inmate advised of opportunity for interview with Su?intendant - - inmate waives gyr?nlt?or Interview with Superintendent Name of SuperintendenUDesignale (Print) . Signature of Superi Designate Dale Sgt. K. Stoffers 20 Sept 14 Sugerintendent Decision (This section must be completed within 5 rings of the inmate's piecemen! in segregation! lmnmeSumnh?an . liM admitted pending misconduct serious assault on. another offender i 1 Superintendent Decision .13 Release from Seggegatjon Continue Segregation m4 Reasons: 4 Name of SUperintendanDesignaie (Print) Slgnature?enuoesignate Date . . c, . ?Uzi/I Segregation ReViewl?maie?s segregation to be reviewed every 5 deg interview with inmate to be conducted every 30 daze) lmnmeSumnbaon . (.0 Suggrintendent Decision Release from Semegalion Conlinue Segregation Reasons: . I 5 Vm Vewiu'w? '50 QC Facing- SmnauneofSupe' enU. mgnam six/- S-ro rm m5? - Sugglementanrjepgrt for each Subsejuent 30 DgyPeriod (use reverse oHorm for additioneicomrnenlsj - Comments i SupenntendanDesignate Signature Date thm?ngy shUR - 5.21 (1) I 050 075-100 (10/04) 000399 30 Regional Director Review Page 2 Conlinued Segregalion '?Commenls 50 I Supponed Ij Nol Slipporled Name of Regional Direclor/Designale (Print) >241 Signature of Regional IDireclor/Designale Dale m} Supplemenlary Report for each Subs?quent 30 Daifen'od (use bottom of for additional comments Dale 0 dado?, Comments Slgnalure I . Continued/Additional Comments by SuperintendenUDesignale Commenls Signalure Dale WLMWA (O/o ?4 I 4 x4?hM2224~4r i?igt 6:453. cidif?g/a mm Mew lo/l?j/?f mam.) \lm? - . Inn me3 Amen ?m'ol N'th LM (A c, cubs-w.- LAS. dogm? Continued/Additional Comments by Regional Director/Designale Comments . Signalure - Dale s.?NlR 5.14l2lldl s.21(1) 5.2 i DI alnbulion: Original - Raglonal Diredo: (only for Regional Dimer Raview) Copy - lnmale File 030 075-100 (10/04) 000400 ha 4 3'31. of Community Safety . and Correctional Services My r/Rx i Name (Last, First. Middle) ??tts?f" {gr/oi ?27395 Segregation Decision/Revie institution Ceniral East Correctional Centre reliant identi?cation Np. ReasoMs) for Segregation Protective Custodi i:i institution Securigr Medical Inmate Request Dale of Segregation 09 Sept 14 Inmate advised oireaaon for segregation inmale advised of opponuntiy for Interview with Superintendent Inmate advised oi opportunity to make orai or written submissions Inmate wattle: oMunity for Interview with Superintendent M. Gnarva . Signature of SuperintenifEDes?aie Name oiSuperintendenUDeeignate (Print) Signature of 3 en enUDeeignaie Date Sth._K. Staffers 10 Sept 14 Superintendent Decision (This section must be compreied within 5 days of the inmate 's placement in Segregation) Inmate Submission . Admitted from 3F - unUSUai and bizarre behaviour Superintendent Decision Ci Release from Segregation Continue Segregation Reasons: - 4r unuhkgaho Bubv?ouaf . Name of SuperintendenUDesignaie (Print) Date inmate Submission No Segregation Review (inmate's Segregation to be reviewed every 5 days. Inierviewwirh inmate to be conducted every 30 days) eta/MIL} El Superiniendenl Decision Release from Segregation Ci Reasons: Continue Segregation Name at SUperintendenUDesignate (Print) Signature 0 ntend UDesignale Date car {20/ lt-(v . I . A SupplementarLReport for each Subsequent 30 D_ay_Perrod (use reverse of form for Comments) Comments SuperintendenUDesignate Signature Date . 521(1) CSD 075?100 (10/04) 000401 ed: v.0 Reg?o?nal Director Review ,Conllnued 0 Modem cu:ij :y?igea IT Net Sugporled Page 2 Name of Reglonal DJreclodDaslgnate (Print) gauges-C Slgnalure? of Regional DirectorfDesignale Date tojz?f/zm?f for additional comments Comments Supplementary Report for each Subsequent 30 Dayferiod (use bottom'of fOrm g?iu?l?m ?M?san Lawn? . Signalum Dale 7 - 4 - (/344di leZO//i/ ConlinuedlAddilional Comments bguperintendentlDegjgnate r? Comments - Slgnalum Dale I Ya I Mali/dam ell-4m .1 Wind a. $7 63/24/11 P?au a Wu}: 0 (BIT?amt a? unmanned) ?o?ka-v?ouv - a Gui/taut}- -?Qa?z?_vi uquuap lac/tuxv . U-mus. ?lung our! 53359 mlelrw I acmw?xckkiwa LBW. 0. ?ber} Continued/Additional Comments by Regional Dire r/Deggnate . Cammenls Z?/nam Da?e . 2 S.NIR 5.21m cso 075-1oo_ (10m; Di: Ulion: Original - Regional Direclur {Only for Regional Director Review) Copy - lnmaln PM 000402 in 10 b.9111 L1 7 - -- . 5* S-afe?L . Segregation Decision/Review a" 0 0? dismissals-H . f- ., - Ontario my exert?) institution . if 7 . . Central EastCorrectional Centre 7 Name (Last. First. Middle) . Ctientidenil?cetien No. Reason(s) ior Segregation Date oiSegregation Protective Custody Security 8 Medical Inmate Request 7 - 24 may 2014 Inmate advised of reason for segregation Inmate advised of opportunity to make "oral or written submissions Inmate advised oi opportunty for Interview with Superintendent inmale waives with Superintendent Name of SuperintendenUDeeignate (Print) - gnaiure (?8me Date K. Staffers. cot/t1? -05-26?2014 Superintendent Decision (This section must be completed within 5 days or the Inmate's placement in segregation) inmate Submission ilM admitted to segregation from MD - Superintendent DECiSion El Release from Segregation Continue Segreg?on Reasons: I .. LC, - m, Lac/Wt c/Lt/L. (Uctr-QC( AW wk. on 11/:er await Name of SuperintendeniIDesignale (Print) Signature of superintendenUDesignate Date COO - 05/29/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Iniervle?r 'wlrh Inmate to be conducted every 30 days) inmate Submission ew_ ab; Co ?swat, Superintendent Decision Release irom Segregation Continue Segregation Reasons: . . Name of SuperintendenUDeSignate (i?rinl) Signature of superintendenUDesignale Data . ?Si/,4 Suppiementary Report for each Subsequent 30 Day PeriOd (use reverse arrorm for additioneloommenis) Comments SuperintendenllDesignale Signature Date -. MdeImy 3.21 (1 I CSD 075-100 (10104) 000403 Page 2 Regional Director. Review . Conlinued Segregallon Supported - Not Supported Comments i Name of Regional DIreciorIDeslgnale (Prinl) Signature of Regional DireclprIDesignale Dale SupplementarLReport for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Dale MMIchfm'y' Continued/Additional Comments by SuperintendenUDesQnate . i - . Comments . Signature . Daie as ?if? ?i e/ we WE Dr. Lemma . . Mill-2a..) - . . I: I 90- IC IT otp/js//M112 A?agmM . ?6 7.5 We aonsfwing/a; (9 WW LOO-L1 Pom-Lid. I c, Continued/Additional Comments by Monal Director/Designate 7 Commenls . Signature Date I 's.21(1) Distribution: O?gim! - Regioruai Diredor Director Review) Copy - inmala Flle 030 075-100(10r04f 000404 Regional Director Review Continued Segregation El Sugponed - Not Supported . Page 2 Comments Dale Name of Regional DirectoriDestgnate (Print) Signature 0! Regional Direct rlDaslgnate FF port for each Subsequent 30 Day Period (use bottom of form for additional comments SUpgementary Re . Comments - Signaturef Date . Continued/Additional Comments tLSuperintendenUDeglgnate . . Comments Signature Date MMIddj'ymrr My Ut? (?l/l4 'iD (LEGO an . I/Z/f?l I. - U/t. to me Mb. with; - bugle? OPEL Um j'tgqquL/lryabaxe Mn WH-NVKS u: WV) LAM . Lin-M 4m?, mi: ?3 lg p.14 (gag ?ve '30 slab M, i mart V3 ?91?va (344? I .. . 315,, [0.02; ILL-J w. a; (D Date Continued/Additional Comments by liegional Director/Designed Comments Signature 1A!Q\lrl\ -- - CSD 075-100 (10/04) Distribution: Original - Regional Director (Only Jar Regional Grader Review) Copy inmata Filo 000405 Regional Director Review Page 2- Continued Segregation Sugporied El Not Supported Comments Backaa? I #6 nurth :iramg'peJAw SLUC page 333mb? Lt? Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Dale bio-QC g?b?,g lo/Z?f/Z?l?f Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature - Dale MNwaVn? Continued/Additional Comments by SuperintendenUDesignate Cements Signature Date . . Ier edic- m3 +0 ow a?x . bed-1ka lo'p7ilContinued/Additional Comments by Regional Director/Designate Comments Signature - Date s.14t2?itd) Dilldbullon: Original - Regional made: [0dr tor Regional Director Review) 080 05400 (1oto4) Copy - inmate File 000406 segue ?e Ministrrof Community Safety . Segregation Decision/Review and Correctional Services . Ontario I . 1 . Quinte Detention Centre Name (Last. First. Client Identi?cation No. Reason(s) for Segregation -I - Protective Custody Institution Security Medical Inmate Request . Inmateadvlsed of opportunity to make oral or written submissions Inmate waives opportunltm with Superintendent . Inmate advised of reason for segregation inmate advised of opportuntiy for Interview with Superlntendent Signature of esignate Date 08/29/2014 Name of Superintendent/Designate (Print) T. Shell . Wu Superintendent Decision (This section must be compieted within 5 days of the inmate's pie mom in Inmate Submission . . I . Inmate very uncooperative and refuses to be placed anywhere other than segregation. Refuses to speak when asked about alternative placement and only requests his canteen. . Superintendent Decision Release from Segregation Ki Contlnue Segregation Reasons: - - I Not suitable or c00perative for other placement. A Name of Superintendent/Designate (Print) Signature of ndentiDes' ate . Date She" A - 09/01/2014 Seg?gation ew (inmate?s segregation to be reviewed every 5?deys. km inmate to 39 conducted every 30 days) Inmate Submission Inmate very uncooperative and refuses to be placed anywhere other than segregation. Refuses to speak when asked . about alternative placement. . - Superintendent Decision 7 Release from Segregation 11 Continue segregation Reasons: I Not suitable or cooperative for other placement Name of Superintendent/Designate (Print) Signature - ndent/De Date - - 09/07/2014 hr cs.? . . . T.- Sheil . Supplementary Report for each Subsequent 30 Day Period (use reverse of form for ad Mona/comments) - Comments Superintendent/Designate Si re Date 7 . a just? 30 days. Inmate said he will not submit a written statement . - but states he is staying where he is. Due to history of 09/29/2014 refusal to be placed in a livingunit segregation to continue. - 60 days. Inmate offered a written statement and said he would do it laterand then declined. Contunues to refuse to 10/27/2014 leave segregation. Segregation to continue. -. (:50 075-100 (10/04) s.21.(1) I 521 000407 Page 2 Reggiel Director Review Continued Segregation Supported Not Supported Comments 6 03?s CMan ~Q?6r-aa _W\ouC-. Name of Regionai Director/Designate (Print) . Signature of Regional DirectoriDeZignate- Date Geo-cc ?ew die/75%- "lag/ii Sumaiementery Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date - ContinuediAdditional Comments by Superintendent/Designate Comments Sig nature . Date Continued/Additional Comments by Regional Director/Designate Comments - Signature Date A Al?\l S. I-ucnd) s.21(1) . Distribution: Original - Regional (Only for Regional Director Retire w) Copy- inmate File cso 075-100 (10/04) 000408 .. his?D, . Zr . 521(1) . . I QUENTE DETENTION CENIBE INMATE sumssm FOR 30 DAY SEGREGATION REVIEWS inmate Name: OTIS Number 1 Inmate written submission for 30 day segregation review: inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) inmate Signature- 1 ?7 . Date: 3/ . i I . Witness Nat-11:2 2; 1" Witness Signature: - 000409 Ministry of Ontario Correctional Services 521%? i Segregation Decision/Review Institutio CORRECTIONAL CENT Name (Last. First. Middle) Clie Identi?cation No. Reason(s) for Segregation Protective Custody Institution Security Medical Inmate Request Date of Segregation 02-Sep-2014 inmate advised of?reason for segregation IE Inmate advised of opportuntiy for interview with Superintendent . Inmate via warm; opportunity to make oral or written submissions Opportunity for interview with Superintendent Name of Superintendent/Designate (Print) WDesignate Date Ed Newman I 03-Sep-2014 Superintendent Decision (This section must be completed within 5 days of the Inmate's placement in segregation) Inmate Submission .- - Inmate is requesting to remain in segregation. Superintendent Decision Release from Segregation '14 Continue Segregation Reasons: - Remain in segregation as per inmate request. Name of Superintendent/Designate (Print) 8' ature fS rintendent/Designate Date Ed Nevirman 03-Sep-2014 Segregation Review (Inmate?s segregation to be-raviewad ever! 5 days. mm 473%}: inmate to be concluded every 30 dag) Inmate submission Superintendent Decision Release from Segregation Continue Segregation Reasons: ?g a. . I /7 Name of SuperintendentlDesignate (Print) ("Signatur ofSu ant/Designate Supplementary Report for each Subsequent 30 Day Period (use rLe?ijerge of form for additional comments . 7 Comments . Superintendent/Designate Signature Date . Day I Month I Year s.21(1) . in 050 075.190 (061%) a 000410 I . s.NlR . s.21(1) Page 2 . . . . 5.21 2 District Rewew Continued Segregation Cl Supported Not Supported Comments Name of District Administrator/Designate (Print) Signature of District AdministratorIDesignate Date Supplementary Report for each Subsequent 30 Day Period (use bottOrn of farm for additional comments Comments - Signature Date Day I Month IYear Continued/Additional Comments by Superintendent/Designate Comments - Date Day-l Month I Year - I . @?ai/MJ git/axe Mmt?m Wm W. Y?Qum? ?mw?w?e; M3 a . Hag-M. Lamb 4 I toga/um Z?i?Se? - J?haiaMA-M a I Primal L5 ?u 9,8/5 I 50563191 wii {7&me Jor Wadi/m Continued/Additio?bl Comments by District Aafrjdinistrator/Desi nate - I Comments Signature Date Day! Month [Year apart?{A 15M . 'okiuem 505.:ng I indan-jrmu maid l; to. 40 woo/elm. mt.? W?wwi?? am/M A KIM/sza) a: moi/35% if. 6M Distribution: Original - District Administrator 0er 075-100 roe/99) kw? I . (O ier?Dis-rric: AdelsiraEr copy - inmate File 00041 1 Page 2 District Administrator Review - Continued Segregation Supported Not Supperted Comments M0763: meg mm?-Te Ha: 13mm Name of District Administrator/Designate (Print) Signature of District Administratoztoslgnato Date i 9 lilo?- Supplementary Report for each Subsequent 30 Day Period _(use bottom ofform for additional comments Comments I: Signature - Date Day I Month I Year Continued/Additional Comments by Superintendent/Designate . - comments 1 I - Signatury/ I Date Day! Month I Year #12074 (emcg - I - @06ch ?27 06774 Mfr/4 i?y??kbozc?cev? Q?aggq/ ?Ka/ .e 5 @Anm?mfnufm?Lm5Mb1 EUACTAQI emw wi?euuo?zrg Continued/Additional Comments by District Administrator/Desicnate - Comments i . I Signature Date - Day Month IYoar Distribution: Original - Diwi a Administrator (Only for clamor Administrator Review) Copy - Inmate II. . 050 075-100 (06(99) 5 NI '000412 I ill. .Qntano, Services segregation DecrsroaneVIew - i i m& rt?r?i 792i it . CE RE Name (Last. First. Middie) 7 Giant Identi?cation No. i; - h?easonm for Segregation 7 7 - .1 Date of Segregation I: Protective Custody lnstiiullon Security Medicai El inmete Request i I 07?M3r-2013 Inmate edvised of reescm [or segregation - I Inmate adviseci?pportun Iy to make oral orwriiten submissions Inmate aovised oi opponunliy for interview with Superintendent Ingm?iaives pportunitgifor interview with Superintendent Name of Superintendenl/Designate (Print) Si ture_of up rl tendenUDeeignaie \Dale ED NEWMAN i 7 13~Mar?2013 Superintendent Decision (This section alusi be completed within 5 days of the WM piecement in segregation) 5 - inmate Submission .Superintendent Decision Reteese from Segregation Continue Segregation Reasons: i - I I i Name or SuperintendenUDesignale (Print) I We) of up rint denUDe'signate Date ED NEWMAN i 1 i 13-Mar?2013 . . I - Segre gallon Rex/new (inmate's segregatioln to be reviewed every 5 dot/WW Inmate to be conducted every 30 days) inmate Submission - Superintendent Decision Releese from Segregation Continue Segregation Reasons: MHI 9% SL3 Name of Superintendent/Desi ate (Pri Signature ofSug?uLo .Dale . . . . 4), I - I. I Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments . SUperinlendenUDesignate Signature . Date 5' DaylMontleear de??t? .i imam i . :i21(2?? - 7 - 030 075-100 (00199000413 DistrictAdr'nlnistrator Review Conlinued Segregation Su poned N01 Suppoded Page 2' Commenls Name of DisLn'cl AdminislraiorlDesfgnate (Prln . I 5 Signature of Dislricl Administralo?Deslgnale Dale for adairion 8! comments SUpplemenlary Report for each Subsgequent 30 Day Period _(use bottom of form 9ommen18 Signalura Dale - Day I Month {Year II Comments by Superintendent/Designate . Comments Signs are Dale HIM II DayIMonlleear . . lo/g?/lj I A ?aw; 0/77 a 775M a . - {111% M191 awn/{rm gab ii 9w xzi/Aj i 5 ., . whim,meth 2,64 M%m0t?m (Olga f7//-5 twain/(3y llowu;m?pajjb?? :0 W1: awn? Ler ma. v7// Continued/Additional Comments by District Administrator/Desi - Slgnalure . . Dale - i Day I Month I Year g: 5 i 3 521(1) OI lribull?nn: CSD 075-100 (OGIQD) Copy - Inmale File 000414' Regional Director. Review Conlinued Segregation Commenls El Supponed Errorl Reference source not found. Ci Not Supported Page 2* Name of Regional Director/Designate (Prim) Signature of Regional DireclorlDesignale Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments '5 (hm/mm 90161 01mm [um AME Comments Signalune Dale ?20 3 4M .514 Tam 1 continued/Additional ??oi?kmenls by Supegint?ndent/Designate I 914% 1&6/3 I Comments jignature ngg?mr 12o dam: (Mg/x3 wi??g' (4'5 Motherly mm 2 Ru: mm 0% (9/77/43 I [ma Li: reef? May/45 mm 75m 9/57/13 5. . . . . imm ??mm (My? T??ah ?410ch 70 . . . a @331? m' I .Uma?m LEW PM) mm LIED-W g/QQ/fg Continued/Additionb?l Comments by Region? Director/Designate - . Cammenls Signature Date S.NIR I s.21(1) Dismbullon: Onglnal .v RegionaIDlreclor (Only for-Regional Director Review) cso 075.100 (10/04) Copy - lnmale File 000415 Regional Director-Revlew . Page $11. Conlinued Segregalion El Sugported - Not Supported Comments .3- TlEme of Regional Director/Designete (Print) Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period'(us a bottom of form for additionatcomm?nts) Comments Wture Date I 9/51/13 7 (ob I?ll) Na mmbor ownproitm?wh 340 own prolecz?m 10/67/3. Continued/Additional Comments t3 SynerintendentlDesignale [l Comments . Signature Date 725 ?m ?00 awfw/cf/M 3/37/13 . 7 Wilmam? - Mamim/LQ [go om?mfeczfm - SMW ?CE/(mu) - Ci/lo/B. ?90 +43 (enact/(X tic/t mm {prolalwit Ci [/57/3 5 - - - I. m?wnm - (A vg?s?z .. 263- it? Mao/1 3, 2J0 0w? PKOWLM ?3/6/13 A Continued/Additional Comments by Regional DirectorlDesignate . Comments . Signature - . Date - 521(1) I Copy-Inmate Flle . CSD 075-100 (10/04) - Dlatnbutlon: - Regional Dlredor {Onfyror Regions! are-cinngqu 000416 Page 2 Regional Director Review 4 Continued Segregation Supported . INol Supported Comments - i i Name of Regional DirectorIDesignate (Print) . Sign'alure 0! Regional Etrmeslgnale Dale Supplementary Report for each Subsequent 30 Day Period (use bottom comments I . UJ Comments I I - I 3%0 I Continued/Additional Comments by Superintendent/Designate Comments A I Signature Date 'aao ?r?wa ?4 lo/l?/IB 99g VMW pro?l??cACz/m -- {take/13 aw $700+:ch . I 10/25/5 axpv?owc?o 10/3975 No ?fime . Viv/'3. C/l 250 'lv format/Lu - ll Wei/l3 Continued/Additional Comments by Regional Director/Designate Comments - Signature . Date - S.NIR b.14i2?dr 521(1) DI atnuultonr Onglnat - Regional Director (Only for Regional Director Review) Copy- Inmate Filo (:30 075?100 (10104) - 000417 Page?? - . - c, Regional Director Review Continued Segregation CI Supported El Not Supported Commanla' Tdame of Regional Director/Deslgnale (Print) Signature of Regional DlreclorIDeslgnate Data Supplementary Report for each Subsequent 30 Day Period fase bottom of form for additional comments Comments Signature Date - - AW Wz?? cm ?fenz?w' 63% (71/ ContinUed/Additional Comments by Superintendent/Designate Comments Signature Date In . 0 .rt/24/13 544? 1?0er - 97o Vlui ?bOt~MA/tbuwm 97S, rape/15 #664 1%;va 385? l/o?mtb?a if)? pro 19/ lei/l5- actovuimwhio. Fahd/rim? {2/478 Continued/Additional Comments by Regional Director/Designate Camments . Signature Date 91(1) CSD 075100 (10104) Dletrlbuilan: Original - Regional Director (Only for Regional Dimcfor Row'a w) Copy - Inmate Fue 000418 Regional Director, Review Pagea'x SuPported Not Supported Comments Continued Segreqalion Name of Regional DlreaorlDesignale (F?nt) Signature of Reglonal DirectoriDeslgnale Date Comments Supplementary Report for each Subsequent 30 Day Period (use bottom of form %Ional comments Date 5% A u, a ?0 6mm I?o?f?c 4% 0' ContinuedlAddltional Comments by Superintendent/Designate Dale Comments Signature I . . Mde/m'r WK low" 'ptfo'mdw' 12/11ij3 500 vuimgab - Wm Fed?1.33% 5 MCon Smaw fol/08/6L 33F ?We 0 Wmf?h?e?a 32L]an 0i Mag rm. 80de d3! ?ay/?75 5 A r?x cum tui-HM? Lm 1004(be Continu?dIABdltional Co by Regional Director/Designat 68w?b9oop Comments Signature Data MM/dd/ywy 321(1) CSD 075-100 (10/04) ?bull an: Original Regional Diredor (Onry for Regional Cn'rccfar Ram's w) Copy - lnmele' File 000419 Page Regional Direotor Review - C3 Coniinued Segregation -r Supported Not Supported Comments Name of Regional Director/Designate (Print) Signature of Regional! DirectorlDesignale Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of/t?rm for 391%! Wants Comments SEW Dale - _4 . 3 Vu?mg??a??wmirom n/ inummhb?e 3 Lain] 3 vu?mohmb?e.? ?m pro Og/o?f/?l? Continued/Additional Comments by} SuperintendentlDesignate/ I . I Cojmmenls l/ Signature Mwigzismr {Tam? :2ng . 33 Eek <9 In (JIM ?k?-CL-Wb?m i OQ/szr/rg? in?rm "beg?J ?45 umb?e EL ?tram 00 MM 355 30.2.1- Wchibl big 02 25M [?op/M f7) LBW 0 2/2 . Mn? (la/MW 8m (DOW 35 \Qc Vac/S Weo?eixg . 360 Cmmw_ i, My ?HG-ur?i emf?to ?vamj?fji?f?i'imsbm?im' gontinuedIAddilionai Comments by Regional Director/Designat Commems Slgnalure . Dale - Disiribuuon: Original a'Reglonal Diredor {Only for Regional Wavior?aviewl Copy - Inmala Fire (:30 075?100(10104) 000420 Page? Regional Direotor. Review - 0? Continued Segregation Supported Not Supported Comments . Name of Regional DirectorIDesignate (Print) Signature of Regional Director/Designate Date A Supplementary Report for each Subsequent 30 Day Period (use bottom of form for adofihio/n omments Comments i Signa fe Mm?algwy . 31% urine/Lathe ib?i?m??n?w??m i w] 4 I o?kwwt? bcdi??rl . - Continuededditional Comments by SuperintendenUDesignate . Comments Signalure Mwagte t. - . My WC WW CLFS at A) 3% m? JD 5?30 WWPw-Erbh SQN?an?tt? ?2 \mcm ?5 ooze/wt 30?, \Wmeka 5 (Mr bm ()4ng VulJrL?Acob?a? a? 000m it make, .0. unity/w. 0U.ch 5015 - D. %00 box,me - ??iafsbm/Jml?bol 5/ (4 of; LAN. - - . weed?! one!) LQ I H0 LW-ijvn Cut-:th m0 if? ?Wit ham. ContinuecllAdditional Comments by Regional Director/Designate Comments Signature M?ggle - My 5.14tzna) s.21(1) CSD 075-100 (10/04) Dialrlbutlon: Original - Regional Director (Only fort-Regional Dr'redor Review) Copy - Inmate ii: 000421 Realonal Diractor' Review Page? L. . sugporled El Con?gued Segregation' v! SUPPoned Commanl: - - . aJahQ-ema?nd 77M on ax . ?an_ .1.ka d?aL?M'ol 90 Irv-?Lair, M1 Md; arms of Regio I Olmclorloesignala (Print) 1 I ?v?wf lgnalure 0! ?eglonal Olmalnrloealgnale Date "05/24/16195 Supplementary Report for each SUbs-equem 30 Day Period (?se borfom of loan [or ear/?it] I omments I If - . comm,? 2 mwaz?me ?\?Cmrn Maia-t ours . Uu?mmo?gik, ?far sag Jw?m qut?h?V-x 963p 01 {um ma. (caum?l' Hem, . - 449mm; um =1 0% I I Con?nuedIAddIitional Comments by SUper?mlendent/Desmnale - Comments Sign!!er Dale MMIddImr $6 Le 30a 04 123/14 ?Jb~fzc\r$ {3'4 04.6.0111 a FYWH {:23 0901110wa41 ma. ?Id-I'be 06/05/l4? 4%..%zars fax ?a?b?bh? 05/15/ Inf q-BSanfz 0:01) LL. burg by] 06/ 187M Continued/Add?lonel Comments by Regional DIreclor/Deslgna( a: Comments _Slgnalure Dale s.21(1) ammo?: emu-dqwmadum far?nabnalamar?aviouj Copanmalq a 030 075-100 (10104) I .- 000422 Page a? _Re_gi?nat Director Review Continued Segregation El Supponed Not Supported Comments Name of Regional DlrectorlDelenete Signature of Regional Director/Designate Date - - - - {1 . Supplementary Report for each Subsequent 30 Day Period (use bottom of form. for eddmo I ommenis Comments Sl n?etur Date 4 . erLhm -- cur/??le/i? Olfle 06lbsj/j? remotedi 99pm law ma ?uent; Hen mbnuA/A um 0U. cal/.4 ContinuedlAdditlonal Comments by SuperlntendentlDesignate Comments . Signature Date - . - Lll5 bile lZB/ml' l+ ?Bar?s v? .04.. Yodttl?a? (a ulsmisgmh '0 c. tlz?v/ Ice}; lo bn 139%th 8rch owes/let l? ?Wm 4-5SM-szo??bm blows by} [con?atq osjiz/ml u~c "l?lo Wm pooled-wa yen-eta? - deM mane)le . git/M . ContinuedJAdditional Comments by Regional Director/Designate . Comments Signature Date s.21(1) Dlalrlnuuon: - Regime! Director (Only (orRoglonal Director Review) Copy - Inmate File cso 075-103 (10104) 000423 Sb Page}? . 2/ Reglonzn Director Review 7 - _Conlinued Segregation Supported Not Supporiad Commanls Name Slgnawra of Regional Director/Daslgnafo Dale /ga ly Supplementary Ropon for each Subsequent 30g), Period {use ballom of r' rm Yo d?h?onal comments) LL50 . Comments Dale Emlde p.14, om ??lri. 3w lca 0? MW 1M UL: Ivarer I . Comments by Superlntendenr/Designale Common); I Slgnalure Due Sexy)? u: ?DUMs-dfeaaw? db M- Sb?m wrih?dx ?3:419szch . . Commenls by Regiona! Director/Designs! . ants Slgnalure Dale 9mm A 2191) Dinmbqun: angina: ch?aul one?, [only maple?: Won'wa Copy- mneIo F110 'cso 4175.109 (10104) 000424 Central East Correctional Centre inmate Submission for 30 Day Segregation Reviews Inmate Name; OTIS Number: Inmate Written submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: 5 21(1) (To be completed by Segregation Manager) S'mef) Inmate signature: Date: Witness NameWitness Signature: - . 000425 ?we I Wifli?ir 550 400 45f Regional Director Review Page-?2' ems ?fibth PEWM UD FWWIM If: (12; am walla/WW {1 Continued/Additional Comments' by Superintendent/Designate [/ll Comments I I Signalure Dale MMIddImyr gubch LA cute/Ls .m?mm Wen-51?O U. 85? WW pm wail?qu Submiser - QM-aaw I . Want.947 Mal/If .LQE). [a .. STD . 4,15 /m ?gww I Vm magmaJ-Bw 01! 07", Continued/Additional Comments by Regional Director/Designate Commanls' . Signalure Dale S.NIR s.21(1) Dlelnbullon: - Regional Dlredor (Only {or RegkmaJ Dlraclor Rodaw) CSD 075-100 (10IO4) Copy - lnmala File 000426 I 2/ Conllnued Segregallon' Supported N01 Supponed Commenls Name of Regional DimclorlDasignale (Print) Signature of Regional DireclorlDesignale Date Supplementary Report for each Subsequent 30 Day Period Jase bottom of Mn fo/ r?lronal comments LI, -- Comments Date 3 . . - 3min LA 4- E, Centrai East Correctional Centre Inmate Submission for 30 Day Segregation Reviews Inmate Name: one Number: Inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) . 5-14i2iidi s.21(1) Inmate signature: Date: Auqust1,2o14r Witness Name: Sheena McWhinnie Witness Signature: 000427 5 ?jmm? Bu.wa - hm 6/17, . ContinuedlAdditloqal Comments by Re ional Director/Des! hate - - Comments 0 Signaturo . Date . . - I 14(2)(d) s.21(1) 5 07/ a2 Q?g/o 2 0 COMiWEd/Addl?onaiComments by Superintendent/Deslghate . comments Slgnelure - Dam MdefymL n; I "?973 5 Page? RegionaT D'ireolor R. 2/ Continued Segregmlon T. Supported Not Supported Comments Pa. an 6'1 Suamu-smu Name of Regl?nal Mentor/Designate (Prim) Signature of Regional Director/D esigna?te Dale ?03 ?o a? ally/20 - Supglementary Repon for each Subsequent 30 Dav Period Jase bottom of 5241; fo ?j?onal comments 3'0 Comments Data LL - "1/7 Mdem 1M t?m?r 4? 6M4 Ema/y 17; garage/6w fu?mmi-?W?Q? - . ., QM. Loni-?ung. 545065?5?01 . MW -5 [hmtev?u- ~75 Eva. Original - WM COW -.lmlo File cso 075100 (10104) 000428 Crag we. 0 461 {Do at? .3 Regional Director Review Page 2 Continued Segregation El Supported Comments Not Supported Name of Regional DirectortDesignale (Print) Signature of Regional DirectorlDesignale Date Supplementary Report for each Subsequent 30 Day Period (use bottom off/0&7 comments Comments //fiy?alure Date [?21,7an 551914 391%; t/ Continuethdditional Comments by Superintendent/Designate Commenls Signature Date 50.342113? F?r'jv - I W,th @3 07? 'L/tq" our-mat I (to {Lg/n; . W?m ?376? 08/01/14 Comments by Regional Director/Designate 3.4 ?cur; Comments Signature Date 5.21 (1 Original - Regional Director (Only for Regtonat Dr'recror?avtew} Copy Inmate File 050 075-100 (10104) 000429 . Regional Dimctor Review Page 2 Continuad Segregailon Suppo?ed Noi Sgpponed Commenia ?og? Name at Regional Direaor/Dasignaie (Print) Signature of Regional Director/Designaie mm Data of 26 1?9 Comments Dale iAdelhw Inmaie [(21 - . I . Supplementary Report for each Subsequent 30 Day Period (use bottom de?ionai commenis yew? .- k. . .. il-i Con?nuedu?Addllionai Comments by SuperfniendenUDeng?ile Commanls Slgnaiure Dale a rip MW. - - 64.33 7 7 i - i WNW (NU May. @9 07) lL/)Ll6?0 mL?bax. meugeawmrzia?Q? EK- . Og/lol'li CohiinuedlAddiilonal Comments by Regional Dimmer/Designate I Comments . Signaiure Dale c. 91(1'1 Distribution: Orighai? Regina: Diredu (Witw?egw aim-1ng vigil) 00W - lrvmio Pu. 080 076-100 (10/04) 000430 - Regional Director?Roview Page 2 Continued Segregation Supported Not Supported Commonls . .5499 we?, r_ cam eepa?ar- r. get-nilpr Sea ??cmcau Queen?505% an 572: fgfem??maoor?? Name of Regional Director/Designate (Print) 4W Signature oi Roglonai DireclorlDesignate Dale cairn/7mg? each Subsequent 30 Day Period (use bottom of fom??ionat comments A Supplementary Report for Comments A Dale 4'1 immW? gate! is? . ?cg-u, 1 A 1. I. WK Hal/1% 1} - tail-Lam -os '64 4d Aggjant .w ments by Superintendent/Designate I . . Continue Com Comments Signature: Date .- 19% newt-?Lehman? baloglli I 1 I gv? 1m o?ioa'i "1i (3 8FrL?s?ck Amt-34m Castro/14 +0 hawk. ft Lukaka 08/3?qu Continued/Additional Comments Lay Regional Director/Designate Comments - Signature" Date - 0?2. earl/Pf Meow/?I1. ?mm a mo U-r a SNIR s.21(1) CSD 075400 (10/04) Distribution: Original Regional Director (Only for Ragionat I Copy . Inmate Filu' 000431 Segregatron Dectstoanevrew Vontario andCorrecttonaiSarvicet-t 4F i 1012/} - i5 Central East Correctional Centre Name (Last. First, Middle) Client ldanii?caiion No. Reacting) for Segregsihm I .Da?rai?oi Segregation . [3 Protective Institution Security Medical Inmate Request I 01 May 2014 Inmate anMsed ofreason for segregation A I inmate advised of opportunity to make oral squissions inmate advised of for inleruiew with Superintendent inmate waives opportunity for Interview with Steerinlendent Name of SuperintendenUDeaignnle (P?nt) A Signature of SupanntanganDeaigr-rate Date K. Staffers, COM1 7 05431-2014 Superintendent Decision (This section must be completed within 5 days 01'th Inmate's?acamani in segregation) I Inmate Sunmission ilM admitted to segregation from SB - hunger strike Superintendent Decision [3 Release from Segraa-ation 3 Continue .4 I Reasons: Qbservatton - hunger strike Name oFSuperintandanVDesignate (Print) . Signature Date L4. Sweccm I Segregation (Inmate's segmgo?r?m to be reviewed every 5 day: Interview with Inmate to be conducted ?wiry 30 days) inmate Submission . Superintendent Dercislan El Release from Segregation Con?nue Segreaation Reasons: I . - Name Signatureo VDesignzte Data 14, 0511112014 Supplementary: Report for each Subsequent 30 Day PeriOdese reverse oHorm rar additionaiaommems) Comments SuperintendenUDesignate Signature Date g; MMIdd/m . . 5.21 (1 5.21 050 075400 (10m) 000432 Reqional? Director Review Continued Segregation Supported Not mis?t-ea Page 2 . Comments 90 aim Innis SVLamb?h? Scar 44 . Signature of?egionai Dir?ctorIDasignat: 4.07.6393 . Name's! Regional Diredarchsignate (Print) 5320;; Date qf/o 5/1/95 Comment: '?me?c?f?b?tjw?m Sugplementary Report for each Subsequent 30 Div Period ?e bottom of Mona! comments} Data Wklde - fA/u M. (L?H'th ContinuediAddi?anal Comments by Superintendenuoesignate . Comments Signature Date MM/ddm'r Na orut 9%i0. 07] ?Nut {h (0&9 .41 ?91371: Wm; - Are-34 . 5 71/5/ij I ?fm oLamh-a 4ML ?305 cums-??nk. 0'1 WW am? @Mm?jg 1021 maxi?m Continued/Additional Comments by R?E?ional Comments . 7 Signature? . Date s.Nl 5.21 (1 chubuunn: Odgimi - Regional Dlrc?a'r (Only (or men/Rbmr) - Copy litmus File 680- 075-100 (10M) 000433 Centrei East Correctional Centre inmate Submission for 30 Day Segregation Reviews inmate Neme:_ OTIS Number: Inmate written submission for 30 day segregation-review: inmate Oral Submissiori for 30 day segregation review: (To be completed by Segregation Manager) Inmate signaturef Date: Aggust 1 2014 Witness Name: Sheena McWhinnie 3 Witness Signature: 521(1) 000434 to?) .1qu- ?Regional Director Review Continued Segregation Cl Comments SUpputtcu Page 2 - Not Supported Signature of Regional Director/Designate Date Name of Regional Director/Designate (Print) 0 a . S'upolementary Repert for each Subsequent 30 Day Period (use bottom ofform fo'r additional comments) Comments Signature Date I MM/dd/yyvy Continued/Additional Comments by Superintendent/Designate I Comments Signature Date AJM ?0,600.4, 6.307%.) .4450, g; - 0? 19/ JD g??tmmim - Continued/Additional Comments by Regional Director/De_sig nate Comments Si'gnarure' Date . MM/dd/yy? . Distribution: Origlnal - Reglonai Director (Only for Regional Director Review) Copy - Inmate Flla C5D 075-100 (10/04) 000435 UGHU dl GESI UUFTBGUOHBI Inmate Submission for 30 Day Segregation Reviews Inmate Name: OTIS Number: Inmate written submission for 30 day segregation review: inmate Oral Submission for 30 dgy segregation review: (To be completed by Segregation Manager) ?nmate signatUre: Witness Name: 8. McWhinnie Witness Signature:8{nm Date: Auqus?so. 2014 s.21(1) 000436 Regional Director Review Continued Segregation mp Supported Page 2 - ?NotSupported Comments 0?6, . ?annzf 52/ Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date K7 beam: #2 p95; Supplementary Report for each Subsequent 30 Day Period (use bottom-offonrn for additional comments Comments - Signature' Date 609 MM/dd/my - 7 'f'D 1 Continued/Additional Comments by Regional Director/Designat Qomments ?c 00/24/z+ Signature . Date eiunz sn4u2xd) 5e21n) Distribution: Onginai Regional Director {Only ro'r Regional Director Review) Copy - Inmate File - cso 073100 _000466 Regional Director Review Page 2 . Continued Segregation - Supported Not Supported Comments . Mme 5m Name of Regional Director/Designate (Print) Signature of Regional Director/De ignate Date -- @4ng (W624 . zo/ar/zow Supplementary Report for each Subsequent 30 Day Period (use bottom of form (Fa/radditionai comts) I . Date I ommen at I I igna ure 0? 3412451; Continued/Additional Comments by Superintendent/Designate Comments Signature Date 25'] Laud?25k; u) page'th-i $3 [/23 3. Continued/Additional Comments by Regional Director/Designate Comments 'Signature Date I 5.21 (1 i Distribution: Original - Regional Director {Only far Regional Director Review) Copy - Inmate File CSD 075-100 (10/04) 000467 to.) Minis?try of Safety - Segregation Decisio nl Review - and orrec iona entices Ontario i' . ?5 . i U: Central East Correctional Centre Name (Last. First. Middle) tent Identi?cation No. - ??e?song) for Segregation . . Date of Segregation . . . . . I 11 Jul 14 . Protective Custody El Institution Security Medical Inmate Request Inmate advised of reason for segregation - - Inmate advised of Opportunity to make oral or written submissions Inmate advised of opoonuntiy for interview with Superintendent Inmate waives opportunity fogmen?ew with Superintendent Name of SuperintendentlDesignate (Print) Signature of SupenntendenUD ate' Date Sgt. K. Staffers . 12 July Superintendent DECISIOH (T his section must be completed Within 5 days of the inmate's placement in segregation) Inmate Submission - Admitted to segregation from 20 - cast on hand Superintendent Decision Release from Segregation Continue Segregation Reasons: I a *4 Name of Superintendenthesignata (Print) Signature of Super? _signate Date Serf Sacramc?: - WIN-IMF Segregation Review (Inmate '5 segregation to be reviewed every 5 days. Interview with inmateto be conducted every 30 days} Inmate Submission 7 Mb Superintendent Decision Release from Segregation Continue Segregation Reasons: 50.9.4.4 PM - Name of Superintendent/Designate (Print) Signature of Wsignate Date I 1 55*? JJ. 9-9::ng . - 'a'I/atffq. Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additiona?cbmment?s) . Comments - SuperintendenUDesignate Signature Date 5 14mm; 521(1) . I cso 075-100 (10/04) 000468 Regional Director Review i' Page 2 Continued Segregation [j Supperted . Not Supported Comments Name of Regional Director/Desig nate (Print) Signature of Regional Directoeresignate Date Comments Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Signature Date? (98 1TH. Continued/Additional Comments by Superintendent/Designate Date - Comments Signature? (19+ 75 WM vA'rLo-?Alew Latvia m; ?402 i QM agedf? Aqua-do tic GK- 2% a. - gaudyA?mcb 4 i Mica-:3 .m ,Lth. Inmate-1L. . (5709?- 3/,5/nl Continued/Additional Comments by Regional Director/Designate 1 Comments i Signature Date - i i 14(9)(d) 5. 521(1) 52112)?) 030 075-100 (10/04) Distribution: Original - Regional Dirudor (Only for Regional Director Review) Copy - Inmate Fila 000469 Regional Director Review Lgomlnued Segrega?on Commenls Supported i Page 2 [3 Not Supported Nu Duh-mp;ng \?n-xd?rx: {am e. scL?cLAcA-? Sf?meAn-s: chcn-f 5.. he; 10+ :i?qn?zc-Lz i h? MEL Name a! Directormesignate (Print) (3.500% Signature or Regional Directpribesignale 63356 Dale )9.qu Supplementary Report for each Subsequent 30 Day Period (use 'boltom of form for addhional comments) Comments - SLq-nalure, DateContinued/Additional Comments by Superintendent/Designate 5' I Cornmanls Signaluq Dale . 0 . MdeW mdacad A?wjafbm #9530 [231/4 ?mix; 01107:. Mm Roma-.A Lao- QM.. Z23 Lb 5 - my swan/M *0 a Lam-1* - claw ha kip/.0 cud-4+ MW Lu ALA-M?smmg baht?$1M w- ,gqu a - 1r :ontinuedlAdditional Comments by Regional Director/Designate 0 Gemmemls - Signalulg Dale 0 . 521(1) '0 Eltmbulfop: Open-J - Rua'mal Cu'e?ur (my Iv?tybu?radww durum: m. so 070100 (10104) . . 000470 Page 2 Reqionel Director Review Continued Segregation Comments D61 Ci Not Supported Er ?Supponed QEm?-u-a w- . 08:73:.? .Su?muhtbw Name ofRegional Director/Designate (Print) Signature ofRegionaiDirectOrlDesignate Date i Gan been 3 07/I?/zorte . Ev Supplementary Report for each Subsequent 30 Day Period age bottom ofform fo'r additiona! Comments) Comments "mature Date i - if MMIdd/yyvy aopmqomLLuo?Anowsgeomoggm? i Continued/Additional Comments by Superintendent/Designate i o'er} 5?5 g< Go Continued/Additional Comments by Regional Director/Designat Comments - Signature Date i . oz/zz/l?Qemm\c??m ?LA-??1ch aq/Ol? I W?rhm wru-i-iov? m5 W'w i Signature" i (D Date Comments S. 521(1) \ul Distribution; Original - Diracinr {Only for Regional Director RsivlewJ Capy - inmate Flie 03o 075?100 (10104) 000471 Central East Correctional Centre inmate Submission for 30 DaySegregation Reviews Inmate Name: OTIS Number: . Inmate {mitten submission for 30 day segregation review: Inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) I inmate signature? Witness Name: S. McWhinnie I .. . Witness Signature: .0 Date: September 9. 2014 s.21(1) 000472 Regional Director Review Continued Seoreoation Comments 2 D?j Suppo?ed 02.7117? .So?miS?ttbur-t: @?tew SE??eE?e??Leu Page 2 I Not Supported Name of Regional DirectorIDesignate (Print) gag-em? Signature of Regional-Directon'Designate Date (Vi/f?/Zol?r- ,7 Supplementary Report for each Subsequent 30 Day Period @e bottom ofform for additional comments) Comments Emature Date 60 7 . - . 145/ l?rCma'kLQ +0 fWCf-km Marts it- C071 I gr I Continued/Additional Comments by Superintendent/Designate Comments Signature Date i . MM/dd/yWyr i 03737719?. 0 h. . I E?oo SYw?jf/al; val/?28 oakl] 1+ medal 63.0. amM-E 52% d; 0&5. cal-30 . 0: i/oEIY/l?l' 99 E1 wit-How Aubw (Continued/Additional Comments? Regional Director/Designate i Comments Signature Date i c'lil? Dlau'lbutlan: Origlnal Rnginnal Dirualur {Only (of Regional Director Rs'vlewj CSD 075?100 (10/04) Copy- lnmale Flla 000473 by? . Ministry of Community Safety Segregation Decision/Review . -. - and Correctional Servrces . 1 . Ontario ,1 meta: t. Ls - a. Central East Correctional Centr Ctienitdenti?cation No. A Name (Last, First, Middle) Reasonte) tor Segregation I - Date olSegregatton Protective Custody Institution Security Medical Inmate Request 12 May 2014 Inmate advised of reason for segregation Inmate advised of opportunity to matte oral orWriiten submissions Inmate advised of opportunity for interview with Superintendent inmate waives opportunity tor interview with Superintendent Name of SuperintendenttDesignaie (Print) Signature of SuperintendenUDeslgnale Dale Mr. N. Neville - 05?13?2014 Superintendent Decision (This section must be corn?ele Within 5 days of the inmate's placement in segregation) inmate Submission Misconduct from GA - chest bumped a CO Superintendent Decision Release from Segregation it Continue Segregation Reasons: - . Misconduct pending Name oi SuperintendanUDesignate (Print) Signature of ni enUD ignate Dale K. Stoffers. COM2 wt - . 05/13/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision Release from Segregation El Continue segregation Reasons: :10. ML CEAH- die/r; Max:104?le Name ofSuperintendenttDesignate (Print) SI nature of Superinl nQenttDesignaie Date cam/15 . I Supplementary Report for each Subsequent 30 Day Period {use reverse arrann foradditionalcommente) . . Comments . Superintendent/Designate Signature Dale 57' 4i?iidi 5.21 (1) 030 075-100 (10104) 000474 Page 2 . Regional 'Director Review Continued Segregation Supported ID Not Supported Comments If Name of Regional DirectorIDe-signale (Print) . Signature of Regional DirectorlDeslgnate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form for ddlilonal comments Comments mum Dale - Mdelmy 0 ?lm 'kContinued/Additional Comments by Superintendent/Designat .- \?83 Comments . Signature Data . A - Mde/yyny '0 ?Pr/1:03 cwaD-A-ad aw-r'wC- - 05d 7 mm?l?r??ww ?Murry-2;? my: hard-4L,qu 4+7?nL?? . '6 a, .2;qu - Aid A mxmxum( I Lid ?u/rawa.) ?how foo-5.1 94004.) . . Egg/mo?tzug m-azmclud; ??253 ate/0t 7m Maw MW wdeli I . i 0.9 000 1% eta/ow . awhile. mm MGM - NW WU 'lwi can", 1% ?42/6011 MI Wb - Re, M4.- 4?0 ea, acute, c1797) H. ,4:th or?. - A I Continued/Additional Comments by Regional Director/Designate Comments Signature Date I . MMIdd/yyw kagixi 5&0 Mow-95604? 4:31ka New mm OG/ro/Mr ?en-v?gal lb/J?uH/H?l s.21(1) Original - Regionat Director (Onty for Regional Direo'or Copy Inmate Fits cso 075-100 (10/04) 000475 - i . i sAzuzxd) CENTRAL EAST CORRECTIONAL CENTRE 5.21 (1) INMATE STATEMENT 5 '1 TNMATE OTIS #4 DATE OF STATEMENAI (1 2 (fa/2W9 0F - 000476 Regional Director Review Page 2 Conllnuad Sagregallol El" SumeHed Not Suppunad Comment: A . CT 9L i Name of Regional Diredarlnaslgnala (P?nl) signaiure of Regional Dheoiom) asignale Dale . I 5M AL [61! supplementgiRepori for each Subsequent 30 Day Period (use bottom of form for/??uonal comments re Dale . MdeImv j?lm?l. hawk.qu 3n: In; Giggle?01 Continued/Addition?l Comments by Sligerlnlendenll?esignate (Smmea Slgnalure Dale . A I (D GF WC. rh?lcn cm?md ?(Wham Ont?9. ?Ls4hxl A mm W?y?dm urn?\qu I Ll. ?u?-I?rP?bh} IWld "a Emoa?? torn-[AWOL mow Luz)?- yrr? ngLw? M)m ?wb'nwm a. 03/01/143 Mai-L?? Vm 710 05% [staid/?19? Re?ux-Anna MM. .4wa Momma, . Qb/O?/l?f" ContinuedlAdd'n?mnal Comments 12y Regional DlreolorlDesfgna Comments signalme Dale - Mde/ywy - ng? CW cud-5iqu [wk-Mg; Mama. Ola] 1.07/ I Tim?=31. lulu-uH/ILJ? O?lld\ vu-I?I, 030 076-100 (10104) Mammal-no: :0er -RM Nada - Oopy- lmula Filo 000477 Regional Director Review Page 2 Continued Segregation Supported Not Supported Comments Name Of Regional DirectorlDeslgnate (Print) Signature of Regional DirectortDeslgnate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments 7 Comments ?ignalt1re Date . 1) - Tiff/[5' 0 ?u I I Continued/Additional Comments by Superintendent/Designate Comments Signature Date (wolf-\m LUEL Subtract? mmogt?e?aa. Moregaib Loom; LAM do: . 60 We demo W?w My $6 b/goym. 5'6 J75?ng 87cm 71M om; Lot No e?mlmwo Pixie-1t;- . .- C?vgawk WWCAPLQJ 1 -Vm anmm}. de, .Coc?pt? (Limit-Ln?- "Vastlk Continued/Additional Comments by Regional Director/Designate Comments Signature Date go 479% 5.21 (1 Dlalrlbullon: Orig'ml - Regional Director (Only for Regional Director Review) Copy inmate File 030 075-100 (1 0104) 000478 - Regional Director Review Page 2 Inmate ?1 ConlanedSegreQallon - Comments 6 duh-b Supponed Ll. 9 No! Supponed Dale whims of Regional Dlreqormasignale (Prim) Signature of RgglonaI DHJAorIDaaignale Supplementary Revort for each Subsequent 30 Day Period (use bolIom offarm comments . Commenls ?nnwm Dale A A MMIddlm 'lZ) Continued/Addilbnal Comments by Superintendent/Designate A Cemmanls Signature Dale 3 5 mqul . Wu. trap/?33: Wage (3 4? za/IL/ VIP Lang. din ?11: ngd' 336 {2/sq?jr 91:94 27/1 No %mev - 8m: MUL- WHM . 5g! - AMchz? EMEL MTW ?95 . Wm 52 ha gom?opt% mmomn Continued/Adah aICommenls-by I?LeglonalblreclorlDesl nate Comments - Signalure 'Dalo . . MMIdd/yyw $21111 Dmt?i?llnn: Orf?hal- m1an {Ori?or?egionu Wwor?emw CED 075?100 (10104) Copy-rimla Fun 000479 Page 2 Comments qo_ ?1 . .Ug?th/Lf Regional Director Review Continued Segregation EL Supported Not Supported Comments 5013*? No CamM-N-p '30 new P??wb Sn? QemGe-rs 25mm": seer.me Rm. manna-n. .Qe-eson-g gale-?7" sTna'cv-mcwr Fara. . '37s Triad-c; Pr hem campec?m Imam-TE Sammie?emu. Pt FHEH. "Emma ?awed? a? 6.6 Siege-:3 ?1 (ism-4:1? Name of Regional DirectorlDaslgnale (Print) Signature of Reglonal Direclor/Designale Dale . . 09/ 5/201? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - Signature Dale Continuededditional Comments by Superintendent/Designate - - Commenls Signature Date *+DAL?anrA?4cp-D?bc. E9) ?1?0 +0 ?12 Lars-:36 ?bandage; - my? ?Lima Ami? Q?Z/ol/ up q; b.6241 markic ?i 1 ?m-?riwm WA . - in ?'gi-gg - w. a I ContiriuedlAdditional Comments by Regional Director/Designate Comments - Signature Dale - A 5 MR 5.41?) - Original-RegionatDlreclor (Ontylor??egianamircdorReviewJ Copy - Inmate File 050 075-100 (10104) 7 . . - 000480 . Page 2 I Regional Director Review inglinued Segregation Supported Not Supported ommenls I cm. 32mm; ewe?, smash. Name ofiFlegianal DirectorIDesignate (Print) Signature of Reglane _ID rectorlDeslgnate Dale Georg beam . 01/ 24: st Supflenientary Report for each Subsequent 30 Day Period (use bottom of form commentsl Comments We Date r5214, mrss?zm seemsszap, I i . weak?? cosm- we. ere-th . MIL, go?amgujw?W lemma. 63 1. x. 7 Continued/Additional Comments by Superintendent/Designate I I . Comments Signature Dale Lat, - - - osIle He Raffw?-?d?qb cl. I I ?1-2 1 'I/g InmaJ-A-mee I . . I 7/3/le a m?m??mrUWA?fa-?Q I - m; 00 3+szqeemmr?q I?m con/v18 0?0 a 9 1: I i Continued/Additional Comments by Regional Director/Designat Comments I. . Signature - Date s.21(1) - I Original- noglonal Director {Only InrReaJonatDirectorREviewJ Copy - Inmate File - CSD 075100 (10104) I- 000481 WT ?f 53?? Segregation Decision! Review 0 and Correctional Services 5 institution I 0?2 i?Central East-Correctional _ntre) Name (Last. First. Middle) . llent'ldentl?cation I "1.4 . Reasonisflor Segregation Date of Segregation El- Protective Custody Institution Security Medical El inmate Requast '09 Ju? 14 inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity for interview with Sui?intendent inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignete (Print) Signature oi Sup rt Designate Date Sgt; K. Staffers . i 11 July 14 Superintendent Decision ?ats section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission . Admitted to segregation from 2F - misconduct pending Superintendent Decision Release irom segregation E4 Continue Reasons: um, c? Nameoi SuperintendenUDesignate (Print) - Siggture of Su erinte enUDesignate Date - i ant-00am i - Mimi I Segregation Review {Inmate's aggregation to be reviewed every 5 days. Interview with inmate to be conducted eveq 30 days) Inmate Submission a 9 v" Mani/g) 17% 3/2) 711) I 0 Eh?tllucnumn nelease fI'Om Segregation ,Conlinue Segregatinn Reasonszi/MLI?C?j/WW i Time of Supe?nten'dentlDestgnale (Print) Signature of SuperintendenUDeeignate . . Dale .J Supplementary Report for each Subsequent 30 Day Period [use reverse orrarm Comments - SuperintendenUDesignale Signature - Dale 544mm} 321(1) 'csoovsdoo (10104) - 000482 325/ 50 Regional Director Revlew Page 2 Supponed Not Supported Continued Segregation Commenls Name of Regionel DireclorlDesignale (Pn'nl) Slgnalure of Regional Diieclor/Designele Dale Comments Supplementary Report for each Subsequent 30 Day Perio?tme bollom of form for additional comments Signalure Dale WA: @153 .l Continued/Additional Comments by Superintendent/Designate Comments Slgnalure? Dale VM err-raw Quit - '9 ,za?mc' W5 (d 67/23/l4 ??mloucmdijf/I?. - o/I/Mm 6,1 A 07/29114 Eh?! {i 08/08/14" mum?. in: save." ?Rcadok '5 41.1)? math-AL: Meow-9v! OMB/lif- - . - ContinuedIAddilional Comments by Regional Director/Designate . Comments Signature Date - s.NlR Dlsl?bullnn: Original - Regional Dirodor (Only for Regional Diredor Review) Copy - Inman FIIB CSD 075-100 (10.104) 000483 S.NIR Page 2 Regional Director Review - Continued Segregation Supported - Not Supported Comments 0 6 g, r? Agar-?We to 1* LNle Um? ~09? -iS'usmtate-o . i Name of Regional DirectorlDeeignate (Print) Signature oi Regional:Director/Designate Dale . {The-mm" . Supplementary Report for each Subsequent 30 Day Period (use bottom of form f9}: additional comments) Comments Wanna . Date . . . -. a 1 I swalld make. WM:Affg'J., .. Sign Ri?TrLg??y?; lk Jd?r?iL/Lw ["Ju I I I ?50 no going Continued/Additional Comments by Superintendent/Designate I Comments Siggnalure: I I WW ?t5wa . or; (8/1 MR 0 I . 8/29/1 I m. "(4244,: mMi-omgh - 3 NM '5 L.ka .l . /k JO Continued/Additional Comments by Regional Director/Designat Comments Signature I Date - 2 . original Regional Dlrectnr {Only for Regional Director Review) Copy - Inmate Flta - (250 075-100 (10104) 000484 .i .. I (m0 1 Eye) Ministry of 90mmunlty Safety 65% Segregation Decision/Review Ontario and Correctional Semces Central East CorrectionalC _ire 2 Name (Last. First. Middle) L3 Cllenlldonlilicailon MJ ncci?auntb) nu: Degregauon . i Dale ofSegregation 1 El Protective Custogy Institution Security Medical CI Inmate Ragga! 09 JUI 14 Inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions inmate advised of opportunliy for Interview with Superintendent inmate waives opportunity for Interview with 3_up_erinlendent Name of SuperintendenUDeslgnate (Print) . Signature of Superintend nUDesignate Dale Sgt. K. Sioffers - . . .. 11 July 14 Superintendent Decision (This section must be con?ded within 5 orihe Inmate's piac'emsnr in segregation) Inmate Submission - - Admitted to segregation from 1 pod - altercation i non?compliant,with staff ICIT required for cell extraction Superintendent Decision El Release from segregation - Continua Segregation Reasons: 7 11 Name of Superinten?dnUDesignate (Print) Signature of Superlntan nate Dale niJ, . . Segregation Review (inmate?s segregation to be revieWed even; 5 days. interview with inmate to be conducted every 30 ciays) inmate Submission . 44_ Superintendent Decision Release from Segregation Continue segregation - I A . II I 1 ..- Reasons: l?Name of SuperinterldenUDesignat?? (Print) Signature Mug?n: Dale . - I?fj?la? for each Subsegyent 30 Day Period (use reverse arrorm ioraddriionai?commenis) . Comments SuperintendenUDssignate Signature Date s.NlR amend) s.21(1) CSD 075-100 (10104) 000485 at?. Regional Director Review Page 2 Continued Segregation Stipponed Comments Not Supported Name of Regional DIrectorlDesignate (Print) Signature of Regional Director/Designate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signalure' Dale. MAL We NM Continued/Additional Comments by Superintendent/Designate Comments tk VJ Signature. Date . . 1 I 7 1 mural; bani 1o .11.an cs/lfjv I Um A?mcu?n ma~ an . ma, watt-(A ire. $1.041 03*; 4 Ag Loom-in hon?A?gpa?n??ttk roe. - LULJU anew-? wont/m ocgm?stmqa?foj emit/amok: 14, 5?4 rut; . ?wanna -4 til-64.4.2 ?ya?L. Lusaka-moth d?f'k $.1an 314M \3 ea. um gm, "rs-th 31-: "lo-s Me.th 0:0 entail I .07/25/14. cm- WW IC- m? . ler?) Aim. - ., u/j. .4, Mp6 04w air/waf?e "C?r?iimm 07/16/ 3f)! V: Angst Q8 ?e.de L51 \ms. certain-Fame 4). 4&3 Continued/Additional Comments by Regional Director/Designate Comments Signature . Dale. '1':th d. WI . - - cook?. tux-\- Am .1 Kg. oslorli?+ Qw?m N-o A ?lrn Aunt-'7 as QL?gs; Qemmiwq. -- "Lsr-?skk Ye?N-?bi??db ?3 cal/oe/wf [Am-l 1L2: I 08/14/14 WAMQWJE Dlalmludan: Dr-ginal - Regional Dlredor (Only {or ?fg?mate?le cso 075?100(10104) W4 - . egionsi DiMarRewei-r} 521(1). 000486 5? {00 Regional Director Review Conlinued Segregatlon Comments' 66b? I Suppo?ed Page 2 El Not Supported Qmau?o 8?1 Cesar; ca? 9% Sem- 90m Name of Regional DirectorlDeslgnale (Print) Supplementary Report for each Subsequent 30 Day Period (us Signature of Regional.Director/Designate ?Date 691-4639 ?09/15/3319? ditch/N2 Comments 0 boilbm of form fo comments ?gure cl WL??/ru. 4- 0m! Acc? Winn Date I on $0104- 9 1/4 0 MM I Conlinued/Additional Comments by Superintendent/Designate Comments 54:9 7,2) nature Date d" Vl'?g?L 0V) ALIA- mote 7?34?. ,r -. l/B?q We: wapia? er'oum I amdatwq heath .ziautinq Imm: Saar?$09 Peaamu?. bra pm?kJ?Lm?m ?rm mo ?jq/l% Ar! /4 Continued/Additional Comments by Regional Director/Designate Comments Signature Date jg] (1) CSD 075-10090f04) Dlalrlbuuon: Original - Ramona} Director (Only for Regional 017.com: Review} Copy - lnmale File 1 000487 i 99"? 4:5 a Ministry ofCommunity Safety Segregation Decision/Review . and Correctional Services . Ontario I Ami-it?--rii9ievw Fr- Central Ealeorreclional Can I . ?r-?Er Client identi?cation No. Name (Last. First. Middle) Reasonts) tor Segregation 7 Data at Segregaiion Protective Custody Ci Institution Security Medical E'inmate Regrujsi . . 7 10 Jul 14 inmate advised of reason [or segregation Inmate advised of opportunity to make oral or written submissions inmate advised of opportunity for interview with Superintendent Inmate waives opportunity ior interview with Superintendent Name of SuperlntendenttDesignate (Print) . Signature of Superlnt Designate Date Sgt. K. Stofr'ers . 11 July 14 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission Admitted to' segregation from ASD - Superintendent Decision Cl Release from Segregation [Xi Continue Segregation ?mm; -11th 609 WvoiJi/tj W?f i i Name of Superintendent/Designate (Print) Signature of SuperintendenUDesignete Date Sm?wH/ume $5462 53.111 1.4 . Segregation Review (inmate 'e segregation to be reviewed every 5 days. Interview with tomato to be marinated event ?40 rtmmi inmate Submission Superintendent Decision Release from Segregation Continue Segregation Reasons: (N . Name oi Superintendenubaslgnate (Print) Signature of So enU?Designate Date M. - Supplementary Report for each Subsequent 30 Day Period (use reverse arrorm roradditionat commeniei - - - Comments SuperintendenUDesiQnale Signature Dete? s.NlR I I s.21(1) C8D 075-100 (10104) . 000488 Page 2 RegionalLDirector Review Continued Segregation Supported Not Supported Comments . - Name otRegionat DirectorlDesignate (Print) . I Signatureof Regional DIreclorlDeslgnale Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments . Slgnalure Date 0L were, ContinUed/Additional Comments by Superintendent/Designate Comments . Signature Date - 5 mg 0mm?, Wtim ?mam 448. - Lipimt. 401 Ambit? cm uni" Mir: 9-3 i??g of, a Q?s. km ?43th I UDou-k?k k9,. MM . a?d?u" k9- M?Loka \Vh? o~ - 173m 3? Chem-me mm?w. uni-tr u. in. 15 4A ((29 07/2?) ck) . I Vv'esvam 'sxekw?SNm- - Continued/Additional Comments by Regionat Director/Designate Comments Signature . Date I - . - 6/ he \ro {0(2 1 3 ?us-hum ru\ an . I, aV/(W/Iqe 4'6 We..er IAN HULKwee 0.9/2er s.21(1) I I C5D 075-100 [10/04) 000489 Centrai East Correctionai Centre Inmate Submission for 30 Day-Segregation Reviews lnmete'Nam?e: OTIS Number} i Inmate written submission for 30 dav segregation review: . . Inmate Oral Submission for 30 day'segregation review: (To be completed by Segregation Manager) 5 MRI s.21(1) lnmatesignatUrei Date: ime?' 1'4 . Witness Name: STcaFf-?dx?g Witness Signature: i 000490 50 Ga Regjonel Director Review Page 2 CI Not Supported Con?tinued Segregallon Er Supported Commenls by - . Q25 gee-v3 'S?cri?a?f-Kou Name of Regional Direclor/Designate (Print) Signalure of Reglonal been?? @1554 Dale 09 I (5/2054 each Subsequent 30 Day Period (use botfom of formJoL additional comments Supplementary Report for Commenls I alure Dale . . - 0 MC - MMIddIym wf-qub ?5 Um. ?Sa- mksarch Angola/[? ?7 mp4 (?Md/t er. grocer/+8 +0 WIW - ContinuedIAdditional Comments by Superintendent/Designate +o AWan mq? Smo? Commenls Signature A Dale - - . I 5 mg, ?lmy?? 9/3/14 Q4. bmr?sSlr/n .0de it ?40.25 A4 5 MM . ?7 Ari/M ContinuedIAddilional Comments by? Regional Director/Designate Dale Comments Signalure MW 5:21 original - Regional Director (Only for Regional Dimcrar?evfewj Copy - lnmale File 050 075-100 (10104) I 000491 Segregation Decision/Review i" ?tter/0e Institution I 1 Central East Coriectidnal Centre Ministry of Community Safety and Correctional Services he) Ontario Name (Last, First. Middle) Client identi?cation No. ueasoms) tor segregation I Protective Custodi t8 institutl0n Security El Medical Inmate Request Date oi Segregation 21 Aug 14' Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opponurLuLtor Interview with S?erlntendent Inmate waives opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Signature oi SuperintendenUDesignate Date Sgt. K. Staffers 22 Aug 14 Superintendent Decision This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission IIM placed in segregation due to past behaviours - assaultive and threatening towards staff Superintendent Decision Release from Segregation *2 Continue Segregation Reasons: . IIM's behaviour has improved - requesting to remain in 569 Name of Superintendent/Designate (Print) Signature iSupe denUDesignate Date . -, 08/ 24/1 Vv Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission ire cs - Superintendent Decision Release from Segregation Continue Segregation Reasons: .Name oi SuperlntendenUDeslgnale (Print) Signature 0t Superinw Date . 1 Supplementary Report for each Subsequent 30 Day Period {:39 reverse aflorm for additional comments) Comments - Superintendent/Designate Signature Date 521(1) .cslo 075-100 (10104) - . '000492 Regional Director Review I Page 2 Supponeo a Continued Segregation - Cl Not Supported Comments 30 reiw?i- f? ?wq DULr?-bh?lw- [43/ at? a{ 50 Name of Regional DirectortDestgnale (Print) Signature of Regional Director/Designate Dale Gee gr?bwt ram/W Supplementary Report for each Subsequent 30 Day Period (use bottom of torrn for additional comments Comments Date Own/Continued/Additional Comments by SuperintendenUDesignate Date Comments Signature Mo ?g 131m -. CQQK . n. i A4 a?/tr/ri?t \rb Lu?: ?atth . igioca?x? Max-dz . . on/M/N . I JxI?Nsok-Nf? Dav/3]] Continued/Additional Comments by [Egonal Director/Designs Comments Signature Date . - Distribution: - Roglonai Dlreuor (Only tor?'cgionat Director Rew?ew) Copy- Inmate File 050 075-100 (10/04)? 000493 ?l . ?3'th 0" Safety Segregation Decision] Review a an orrec Iona emcee Ontario tiller/(1446i . w, institution i?n?lnk?ii Eat i . . Central East Correctional Centre Name (Last. Firet..Middle) Lt . 1.1111111 Client Identi?cation No. . (Nan? .- {Lag - Harmonie) tor segregation I Dale of Segregation . . . 08/28/13 Protective Custody Security Medical Inmate Request Inmate advised of reason tar segregation Inmate advised ot opportunity to make oral or written submissions inmate advised of opportuntiy tor interview with Superintendent Inmate waives opponunity for interview with Sgperintondent Name of SuperintendenUDesignate (Pn'nl) . ature of Superinlen enUDefignate Dale 3. McWhinnle (Y) (14.3 . 08/28/13 Superintendent Decision (This section must be completed within 5 days of the inrnate's placement in segregation) Inmate Submission bizarre behaviour . - unpredictable subject is completely unresponsive - will not speak or make contact. Superintendent Decision 1] Release from Segregation - i - . - - . Continue segregation Reasons: I - i . 5 day review - inmate dispays bizarre behaviour - unpredictable . Name of SuperintendentlDesignato (Print) Si nature of Superint JanUDesignale Date I s. McWhinrtie g; 7 69102113 I t. Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be Conducted every 30 daysmate Submission Superintendent Decision Release from Segregation El Continue Segregation Reasons: Name of SuperintendenUDeslgnate (Print) Signature of SuperintendenUDeelgnate Date Supplementary Report for each Subsequent 30 Day Period (use reverse ottorm foradditionaicomments) Comments - SUperinlendentiDesignate Signature Date . - - s.NiR s.21(1) CSD 075-100 (10104) (3 000494 Regional Director Review P. 3e - Our miracle. . ?Emu-M3 res crux-510$? [1.41, Lu Bio 5,4- ENCLP Continued segregation Supported Not Supported Comments . - Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Supplementary Report [or each Subsequent 30 Day Period (use bottom of form for additional comments) Comments - 6/;ignature - Date '1 A .?oclaqs ?4 Continued/Additional Comments by Superintendent/Designate Comments Signature Date A. i ?0 bizarre 9/3/11; ha uimv non-(teponeiu-esmoa I . 9/1174); .26 Ma? Wm Jul/b EMU I wag?" 9/5503 300M urn Jamie? ?errata Eris/1W Mal/15 $6 10 [77?s. )o/nl/B Continued/Additional Comments bi Regional DirectorlDesignate Comments Signature Date 5.21 (1 5.2 i Distribution: original - Regional Director (Only for-Regional (Nectar Review) Copy - Inmate File CSD 075-100 (10104) 7 000495 Regional Director Review Page 2 Continued Segregation Supported Ci fNotSupporled Comments A Name of Regional DirectorlDesignata (Print) Signature of Regional DirectorlDesignale Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of {cap for additionelcommenls Comments flgnalure Date . - - 01de i WM 300005 {Mow he - Writ/l3 ContinuedlAdditionat Comments by Superintendent/Designate comments Signature Date A . . i )0 i404 . b4. mum: n-bn-rtsponecu-c Smog. - - . OJF ?Ema-W 1* Warts I?WUin?mEm+' Wye/1211 - We . ,9 457-155 ?Lilia??. 5' 35AM Wmcumii-ol 9/29! 3. gd [Ma??ioJ-Z 4g (D Continued/Additional Comments by Regional Director/Designat Signature Date Comments s.NlR s.21(1) Dislnbullon: Original - Regional Director (Only for Regional Dirador Row'emt Copy - Inmate File 030 075-100(10104) 000496 Page 23 Regional ElirectorReview Continued Segregation? Suppoded - . lNoi Supported Comments I -- Name of Regional Director/Designate (Print) I . I Signature oi Regional Dire clorfDesignale Dale - Supplementary Report for-each Subsequent 30 Day Period (use bottom of form comments Comments I I Sari-?lm I I A um didah? IL. ?o ?can?? 5% - 10/27/13 Continued/Additional Comments by Superintendent/Designate Comments Sig lure 'Date . A 6o mpa?hio 10/17/5. 5? 10/11/13 9? Miowa ?an cmm- Io/z'ai/xs as Moll/13 70- WW?th - - own/AW M04713 wmp'w?bbs H713 - 80 wwmpa?w - @4604. - [?t/13 Kiwdxwalzrm/rc)13 Continued/Additional Comments by Regional Director/Designate Commonls Signati'ire Dale NIR 5.11?) . Distribution: Original Regional Diroctot (Only for Regional Director Review] - - I Copy~ inmate Fil? 030 075-100 (10/04) 000497 Regional Director'R?eview Continued Segregation Supported . - CI Not Supported Comments - 0 Name of Regional DirectorlDesignate (Print) Signature of Regional DirectorlDesignate Data - SupplementaryReport for each Subsequent 30 DaLPeriod (use bottom?form?rp?ional comments - Comments . Date A inWodibLb. ~biwr? ?lag/IS? 0 min int/C4me . v/ . I iai' cert-c. - loo . i1 Zia/rs. ContinuedIAdditional Comments by Superintendent/Designate Comments Signature Date I Q0 8 Loo (/20 ?ts? Wwemw I 04 MB . too WW-Pk?d??g tale/13 was We - Valli/l3 no . 8 ?2/0/13 ?5 ?m'cD/w [2.72.1713 SMdD'tr/rw - W147 '3 ms momma git/160w - Continued/Andittonal Comments by Regional Dimmer/Designate i - Comments Signature I Date s.14(2lldl _s.21(1) 3.21 DIetrlDu uon: Original - Regional Director (Only for Regional Director Re View) . . Copy Inmate File 080 075-100 (10104) . 000498 Page 3 Regonal-Director Review 7 7 Continued Segregation Supported . Not Supported Comments . Name of Regional DlraotorlDosignato (Print) Signature of?egional DirectorfDesignate Dale Supplementary Report for each Subsequent 30 Day Period (use bottom of forty/f comments) Comments 9 re Date A 556- Crc?la v-C. ?Wt/vi I A. - . . Sailor-e. bat/moo . we Vt lo ro+ccft wring/H- Continued/Additional Comments by Superintendent/Designate I Comments Signature Date MMIddImyr ?2 bi. awr?lgal'm [do RMaE-?ww Ol/os/H' C, I . I Nb (Ibex - 1.110 ?burn (0 Jr?qcz mm. (W. 6Ma9/Wv 6m 4.1-, - 5 r3935; WW.- logctr rte?gt m?wmp~t; em dole-1w ol lac/1% v. +0 (.9 maix {3?4 '50 balm: mom/t. 5Q cum pro lea-Low OI 'Louu i ng lt?wc wl??xd?C g/Qe. be, 01 50 L. mama Fad?r [9 b?l Ov?f?c, ball/Lou): a KX-cuM,Oajlm . 224 07? Continued/Additional Comments by Regional DirectorIDesignate Comments .Slghalure Date - s.21l1) Dietrioull on: - Regional biroolor (Only for Regional Dirador?otdew) oso 075-100(10104) Copy Inmate Fne 000499 Paged. Regional Director-Review Continued Segregation El Supported Not Supported Comments Name of Regional DirectorIDesignate (Print) - Signature of Regional DirectoriDesignate Date Supplementary Repozt for each Subsequent 30 Day Period (use bottom forp?forjaddilional comments) I Um -- 02/277/4 ContinuedIAdditionai Comments by Superintendent/Designate Comments Signature Date -- 8m LLB/wee mg; . ?ing I - . a, I a {Cbobm Pigiaani/wrfm 135* -imcm?aJ'E?L \Q?akadu?ldt-Lr? I la?) m? ?g 03/ii//L7L? 300 bow/?? @ojcg?i-hct (ism/r7!- (so/Zuni Continued/Additional Comments by Regional Director/Designat Comments . Signature - Date - 5.21 (1 1mm Original - [legions Directot {Only for Regional Director Review) Copy - Inmate File .030 000500 Regional Director Review Page123? - I Bil/1W ?1 3 Continued Segregation Supported 7' [3 Not Supported Comments 7 Name of Regional Director/Designate (Print) Signature of Regional Directori'Designale Date Supplementary Report for each Subsequent 30 Day Period (use bottom of roM for mittens! comments Commenle Wat to Date i . 1 . sew?own . ioqu wxeaseem sec/ma . A dame/1+ I?Lavlreb? 4.2/71 (a-tfoW' ewe e-Wm?w oils/[Li - . ?1.10 WP _mu ?(may ?7 . Continuethdditional Comments by Superintendent/Designate Comments I Signature . Date . . .. {gimme bet/moi ?Wb?r?p?d?l twp-feat? 092.15 03/29/14 3'5 bik?-DlouL?r r(It Sit/i'abtgw .oStat/I I. M: thLW/p "t?b . a? 9:3 Joni/To mim??rofta can 803% owes/Hf 0.330 I May/mt, ?tampzu?g?z 80?) (43W oat/6M 955 e- bawf??jz/QJI 024/2, 04/25/91 I %m 8 SW) Continued/Additional Comments by Regionat DIrectorlDesignat 07/3@0? Comments Signature 7 Dale 6721(1) Dlulributlun: Original - Regional Director (Only forRogkmaI Director Review) Copy? Inmate Filo cso 075-100 (10/04) 000501 RggiQrIaIDlreclorR?svlew 'Pagez/ Con?rmed Segregation - LE: Sugpodad Nol Supported C3222 Wm ba?ambw. 401 A4 rho-?4 mlsw??naesg?r E: '24?9 1.3g: . . . ?(go Ma?a gubm'?la? 9:5 ?J?g pct/3'ch cud am; of glonol (Prinl) Slgnalure of Region lDlleclon'Deelgnala 0'31: ?uff 1&1va Supplementary Report for each Subsequanl 30 Day Period (use bottom offal?13% a?onai comments CommenIs Dale . Mdefywv a mm. Eh; ?60 ko?mmq LIA mare Launqu W0 owns/Continued/Additlogg! Comments by Superlnlendent/Deslgnale Comments Signature Date he?th an - a?gforom?o km no man Whom, I 057155/[4 o'S/lo/ILf 94,057: me, u. W-ywn mtcc?im- i 0W7. dq?rm amiG/fgalommgmu??m?op @mwmg 05/15/14 My - Exam; MM, prokJ-om 93m 06/10/14 I . Continued/Additional Commenls by Regional Director/Deslgnate Comment: SlgnaIura Data 1?2?d) s..21(1) DlAthqun: mehml Dlruolor Cow-Imam Fllo cso 015.100 (10104) fr mu '_000502 o-u .u-u Page 3 Reglonal Director Review - - a Continued Segregallon Supported - Supponed Comments Name of Regional DirectorIDealgnale (Print) Signature of Regional Director/Designate Dale /l I Supplementary Report for each Subsequent 30 Day Perlod (use bottom of for or a?onal comments I Comments I I any qur?rt be abowwb- c_ we to i; 4 W?m?m?mtmn Osld/l? +0 ?aim Mms?mContinued/Additional Comments by Superintendent/Designate Comments - Signature Date - aimlwa bahwlmu. 8 - 05/65/14 . o?/ro/ltf 5" I .. vv . gear magazmmgim?mw bans/14 abb?Korra?Juolm ?mprolmem- 06/10) - I MOMM ma?gg??w? 63M 05/25/14 - ww?w l, Vi?e?etm?t??z?m W- ?g Maw/1% - 'Sfeeuk MA WIN a) Continued/Additional Comments by Regional Director/Designate Comments Signalure' Dale 5.21 (1 - Ramona! Director (Only rorRe-glanal Dr'recrorReMsw) Copy - Inmate Flle C3D 075?100 (10104) 000503 RegiIOnal Difecior. REVIEW I Page 51 (0 ContihuedS'} a1an LSupported flak. ?f 41 lam cute. I. Com I. I No.79. [3 N91 summoned ?lm? Name of Regional (PM) - fm fie?4M 4*?wa Signature of Regional E?morloealgnale Date Supplementgy Report for each Subsequent 30 Day Period (use bottom offDr/p?fgr a?onel comments rwwb? 0 - OrOjfd'EJW?q'w?f?v I a Con?nued/AddHIOnal Comments by Superlnt?ndent/Designate Comments - Signature Dme a - - 355,6 ram V3 (It?th WIM - +0 pfy?ktl?L/?ngl ?3 06/15/156 awn m4 9605'- ?gm? mmM- W. awre??etuu:m Wm p'rokcf'ofm 06/20/14 I Lg x! . 310 Eva-5A 05/25 I 17-} ?aw?A VA - 3?11Comments by Rggional Dlrector/Dgsignate comments Signature Date Cow-Mum- 030 075?1100 (10104) amm- Ream from {Mbh?my alraaor Radon) 000504 . Page! I I I Regional"Director Review Continued Segregation El Supported Cl Not Supported Comments Name of Regional Direclon?Designale (Print) . Signature ol Regional Dale Supplementary Report for each Subseduent 30 Day Period {use bottom of 1?0er for additional comments Comments . thziltle 'chi'nwtok oPPodru.?\ er.? +0 {oufolc - ?ll-nA-cmc? 'chmeAh \nP ?Se?ma i 0 Quasi \xl-b 'pfoka?l-?w-n 5 Continued/Additional Comments by Superintendent/Designate . - 916 7 4D Comments I Signature MMESEWW gund?'wx on gun 6.917)? t" Max 54:? VH7 . 1% . 051/ 30/] I - ?9-80 amn??'nm 44.4%? Whoa/k.) I - . (tag-459,449; A:?o ?Ange: .. . Esra?Wed 4.5km- - a . obloql? 3.110 Cw- t/m oe/ra/ILF 90.5 away/MC) LIG- i 4v Mallow mm) bgapn Ayn?: Movfou we - . 690 I gnaw/1K 1.4/01 alto a?/gq/?f Continued/Additional Comments by Regional Director/Designate 5 Comments - Signature Dale s. Ill-(And) s.21(1) - Distribution: angina] - Regional Din:ch (Only Ior Regional Director Review) Copy - inmate File (:30 075-100 (10104) 000505 3'15 #80 Pagef .. Regional Director Review Oon?tinued g' Supported Nb! Supported - reg? 4&0 (3320,; Corn em: \Deeb; (1.13 [mack I Signature of Regional DIrecIoeroaIgnaw Name ol Regicmal Murmur/Designate (Print) I ?eck; $3434.: I Date Supplementary Report for each Subsequent 30 Day Period (use bottom ofform?f?addhlonal comments baa-LhuoL DPPci-kuxhk1 +9 Fax/outcla? Date 04/23/250 Commean $900041? . 1e?; $ch M: pro-ko?m 3-) . Superintende?ntlDesighale - 'v slgsa?w' Om 235;?; m2; at"? 5 V4 lo (,1me 12,, 4., 00/04/14 i?m?i' . ?a 1m oe/wzuf/pf' Rem-Lu ?a +5 Jib aa/m/MF- Jo Mae-rob m. mm.? wW-wk- -r Momhglto?fi?hamj ContunpedlAddmonal Comments by Reg anal Director/Designate 00/9 Commenls Signature Dam MM/dd/m 5.21 (1) 5.4 i or?bmm Grimm-Regina: Cch- Inmm Fla cso 075.100 (10.04) - 5 . 000506 '1 nllz'nu Inn- -..-.- . Central East Correctional Centre inmate Submission for 30 Day Segregation Reviews Inmate Name: OTIS'Number: . inmate written submission for 30 day Segregation review: I. s.21(1) inmate Oral Submission for 30 day segregation review: (To be completed by Segregation Manager) Vm- Vegg-gA-?Sw mpknoosw 33m}? - l\ . mt??h?tn il'bmuvu?au: w, Vm A .mn comhwx?j" mom Pp??ckxoLc-exj 13,144.? - - inmate signature: - Date: iO'kUlaumo - iq Witness Name: ?70 PPM i 0 Witness Signature: I - - . A con-0.x? ?bf (Q 000507 I No 9W Regiona'. Director Review Page 2 CI Supported Continued Segregation Not Supported Comments Name of Regional DirectorIDosignate (Print) Signature of Regional DirectorlDeslgnale Dale '.Sugotementary Report for each Subsequent 30 Day Period juse bottom of form for additional comments out . . Signature to @335) no MALgmo? an any/4% Fthf/t?rm . I \vxanLtQ- ?4+0 mat/6.0. a ?11. I WM . Mam-mnxl 40 I . may? I - - 1/ MW Continued/Additional Comments by Superintendent/Designate I Comments nature Dale - 6 40 ammo-tn task.) .44 :prt'pe) 0 - un?DM?bCa +5 . HM pro 3m WA-?om?urf; 4 ?tamed tum m_ a 07/00/ d-e . LU?tol I ?ammo 7.4mm 3615 ?M/taulcwt.? 'dm I155 bf 7 1?1: on A0 a our Lan?j I wawomsfu-c. raw?40 41:, rho/?0 wide 4 p.11 0?1. (moi. Kiev?0?- Conttnued/Additional Comments by??egionat Director/Designate Comments Signature Date I 3 21m - Distribution: Ol?vgtn?l - Regionut Director (Only for Regional Director Review) Copy - Inmate File (:30 075-100 (10104) 000508 Page 2 ?glone? Director Review ConlInUed Segregallon Supported No! _S_l.l_lzponed Comments l' I I :ma?ltn WM Name a!RegionalDIreolorlDeslgnaian) Dale 42% am ck Mai/w SjigLementary Report [or each Subsequent 30 Day Period (use bo?om of form for addilional commenfs - mo JLQ co margin? Mega? ?/zyjig?l?lm 53042.4 1h - (931/1 . A Map +0 MAPIMA 41.3 :n I 'u?m 1 mm 00%" ?i . - mm Comments by Superintendent/Designate (I 0 . Commanls V7 Erm?alwe Dale 0&devany Lin-J' -4241?! W) a . .qu; 9-. raf?d?C?F-?r - - 3x0 igkhduwc? m; 07/09/ . st; mbLa. . I. . A 1 .LLAQM 06a. canal?cm a. I . $515 yAau/cm ((Ame Helm 7A 7/14 +5 on A1er Una; ?s?mmef? nub uni-?? 01 01.0.2. Mm7551%_ Commenls by Regional Director/Designate Commonls $lgnaluro I gag? - MM My S.NIR - 521(1) alemouuom Odenpl- nogw Nmrlomfw?agbnal Music/Miriam) . - . Copy?1mm ?000509 CSD 075-100 (10/04) ottb 345 55:5 343(- 131:0 Regional Director Review Continued Segregation Comments sugponed Ci Not Supported Page 2 Name of Regional DirectorlDesignato (Print) 1 Slgnalure of Regional DIrectortDasignate Date 1 Supptementary Report for each Subsequent 30 Day Period (use bottom of towel; additional comments - Comments Sig re Date - 03/22/20? Continued/Additional Comments? Superintendent/Designate Comments Signature Dal'o. - . ?chs i i mmvd? osioq/iq?v ABV ch. \im it: ?$5111.55 \onNV.? m3 Jirod?. . NU ten-5A.. cL-wee?am 19:41.. Last-c. 59, @ngg?r\: . toilet/(51L be i eons? #4325 2 - . . twa?w my hf) ?:22 . ?skin-Nev? . Continued/Additional Comments by Regional Director/Designate . Comments - Signature . Date I 521(1) 5.21 mm 030 075-100 (10104) Distribution: Original - Regional Diroolnr (Only for Regional Director-Review) Copy - Inmeie File 000510 346 1,47 3w Re?ne! Director Revlew Canunued S'EQregallan Supponed . LJ - plot - Comma-ms - lb and?c; Wen 4; Wag 649 mot map/mail Namo'ol Rnglana! Direclo?Designale (Pn?nl) 52935?4 mam. Hue-4 exp/51459;? S(gnalura of Raglahal Dhaclor/Deslgnah maint- DEIQ - .0710 'r/zol?r? of {am additional comments Supplementary Report for . Commanla each Subsequent 30 Day Period (Use bottom Dal oX/Z2?01y Comments by Superintendent/Deslgnata w. Ila-A" \Im 3CD 9?e5sh?3?'m (av-u Commanls Slgnafure Dale. - 1 e.st u?oy?as pan-s bra, . \imbkn 3m ?w.an o. - kt\mwm.\ Vault?me "\13 3N . d. .. cm? 135 ubUr?L duw-ay?h?w? as} - wjosv/M - w. . 03))w?w" I . .?qgwe, OK I 7,3] Continued/Additional Comments by Reglonal DirectorIDeslgnate - Commanls Sbnalurd- Dale I 5. 521(1) mammal on! Original 499an fochgbuImedw Raven) Copy - lNM?la He (:50 075?100 (10104) 000511 Regional Direclor Review Conliniled Segregation Comments EDi'zou-re. ?i SUpponed chd?6o l'La. PhD-avg, simian. gob ?lnmc?l J. a: Not Supported Page 2 . Name at Regional DireclorIDesignale (Prinl) Slgnalure of R?gionaliDlreclor/Dasignale mar Pale )o/Zf/k/y Supmlementary Report for each Subsequent 30 Day Period (use bollom of form foFaddilionel comments) Commenls Signature 'Dale 2:90 MMl?ddl?my ?Unto/m5 md?b amat?Mn ?Ana-?[Woman/a JE . WW rum 5 Continued/Additional Comments by Superintendent/Designale . Commenls Slgnalure' Dale - I Lab kokn B'IZarr?. i?qplfawp ELDMWOILQ ?co. 42?: WEK 3.9? 1.31.4 01.44.} 07/0L/f?. I i aim/1mm} lbwme ?A2ka 1 575? 5 3i Q4 ?i/IZ/?l 393 (Rt-4x53.? .uo-o Art-A lam? oq/Zo/I? det UYLCL - (X Laue?; mm?ok. fly?Eu}? millime- amou?ooulo.woa . Continued/Additional Comments by Regional Director/Designal (D Commenls Signalure' Dale Mldd?w' S.NIR . mm?) 5-21 Original - Regional (Only (arReglonal Dimclor Review? Copy - Inmala Fila oso 075?100 (10104) 000512 - i of Ministry of Community Safety 1i Segregation Debision/Review by.? - - and Correctional Services - i. - I . fit-felt?? =4 Institution Central East Correctional Centre Reason(s) i0r_Segregation LI .2i i 195 Name (Last. First, Middle) Client Identi?cation No. Date oi Segregation 19 Aug 14 Protective Custody El Institution Security El Medical Inmate Request inmate advised of'reason for segregation Inmate advised 0i opportunity to rriake oral or written submissions Inmate advised oi opportunity lor interview with Superintendent inmate waives oppo?ur?mw with Superintendent Signature oI Superinten Date ween? Name of SuperintendenUDesignate (Print) Sgt. K. Slotters __Superintendent Decision (this section must be completed within 5 days of the inmate's placement In segregation) inmate Submission - IIM run from all units allegations of muscling other offenders El Superintendent Decision Reasons: Release from Segregation Continue Segregation w. naps} - Date 08/254 Name of SuperintendenUDesignate (Print) Signature otWDestgnate' Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission - El El Superintendent Decision Release from Segregation Continue Segregation Reasons: I I a;ng ?j Misc/bin? - I Name of Signature of nde Designate Dale Supplementary Report for each Subsequent 30 Day Period (use reverse of form ror additionaicommonts) Comments Superintendent/Designate Signature Date . s.21(1) 5.2.1 cso 000513 91 5?22 4 Regional Director ReView Conlinued Segregation El Supported [j Not Supported Page 2 comments 30 Maia. outer} Edict) ?ih+erc??= 30 Name of Regional DirectorIDasignate (Pn?nl) Gee Signature oi Regional DirectorIDesignale ?f?r??agi? Dale /0/z ic/zot go Commenls Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Date ??alum . 0? ll Continued/Additional Comments by SwerinlendenUDesignale Comments Signalmo Dale (Qt-9Lth m'm M1 ml/Icg7/Iqi \im oJLauh'cM-Dk w?ag owe: gm cal/21,14 R-ewxwa. M~~uh oSt New- CD Continued/Additional Comment's by Regional DirectorlDesignat Signature Comments Date c. 911?1; I Distribution): O?ginal - Regional Director {Only forReglonai UraclorRevlew) Copy - inmate File (:30 075-100 (10104) 000514 lay a it; VPOntario Ministry 0? safety Segregation DeCisionl Review and Colgecttonat?svettvices? - D) rev/4w Di? I II . Central East Correctional Centre Name (Last, First, Middle) Client Identification No.. Reasonts) tor Segregation - .- I Date of Segregation Protective Custody Institution Security Medical Inmate Request 19 Aug 14 Inmate advised of reason for segregation Inmate advised oi opportunity to make oral or written submissions Inmate advised of oggonuntiy for interview with Superintendent Inmate waives opp?ri'tmily for Interview with Superintendent Name oi SuperintendenUDesignate (Print) Signature of SupenWsignate Date i Sgt. K. Stoiiers 22 Augi4 Superintendent Decision his section must be completed Within 5 days of the Inmate's piacemeni in segregation) Inmate Submission . IIM requested segregation fears for his safety Superintendent Decision Release from Segregation Continue SegreLaiiOn \Reasons: bi Signature of Superim d9 ,Ie Dale l. 08/ we Name of SuperintendenUDesIgnaia (Print) Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission _i flighwt-tmb 'ww Superintendent Decision Ci Release from Segregation Continue Segregation a as so. Reasons: MW :rvs Name oi SuperintendenUDesignate (Pnnl) Signature 0 ntIDesignate Dale el? - - on /oI wt Supplementary Report for each Subsequent 30 Day Period'(use reverse orrorm for additional comments) Comments SupennlendenUDeslgnale Signature Date 521(17? I 050 075-100 (10/04) 000515 ?a 9K ex Regional Director Review Continued Segre?on Comments 30 i Ea~ Supponed Not Supported . stable OraL?wiHe_ Du?b AL - Paige 2 Name of Regional DirectortDeslgnale (Print) @6342: 34? u: Slgnaiuro of Regional DireclorlDelenate 1- Dale 10/194101? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Date [0 Signature - 1 . Continued/Additional Comments by Sugerintendent/Designate Comments . - Signature Date . . in: Wanm 0 3M ole?n MUM it on/iel/zkt ?1 . W, {.94 hung-y '4 #0 mm? ng??w <53 ..g53 g2? 'O?tlzo/N Continued/Additional Comments by Regional Director/Designat Comments Signature Date MMIdd/yyvy 5.21 (1 I Distribution: Original - Regional Director {Only for Regional DirectorReviaw) Copy- inmate File (:30 075-100 (10104) 000516 of? Segre/gatron Decretoanevrew Ontario i Di ?ve (is liz-Ci i institution I . . . a: 3? Central East Correctional Centre Name (Last. First. Middle) - Client identi?cation No. _Rason(s)' [or Segregation Date of Segregation Protective Custody Institution SecurllL [2 Medical inmate Request 12 14 Inmate advised oi reason ior segregation Inmate advised of Opportunity to make oral or written submissions inmate advised oi opportunity for interview with Superintendent Inmate waives opportunity or interview with Su eriniendeni Name of SuperintendenUDesignale (Print) - Signature of SuperintendenUDeisignate Date . Stofiers - i 16 July 14 Superintendent Decision (This section must be campieled within 5 days of the Inmate?s piacement tn segregation) inmate Submission Admitted to segregation on suicide watch - i . I i - Superintendent Decision CI Release from Segregation L's Continue Segregation Reasons: gbw??V?L'? o3. kt "sire-?Wk: up Name of Superintendent/Designate (Print) Signature of Superinie nUDesignale Date . . eta-r. (gm-53% ?lm-[rut a 'i Segregation Review {Inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission . - Superintendent Decision Release from Seg?galion Continue Segregation Reasons: - - Name oi SuperintendenUDesignete (Print) I Signature of Superi nden dsignale Date . Ag: ?752 07/ I i Supplementary Report for each Subsequent 30 Day Period {use reverse arrorm for additional 'commenis) Comments SuperintendenUDeslgnate Signature Date - . CSD 075-100 (10104) 000517 70, 510 3'1 ?51/ r. i i "Page2 Regional Director Review lSUpponed Continued Segregation Comments 1 Not Supponed Name ol Regional DirectorID_esignate (Print) Signature of Regional Directoripesignale Dale - Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature . Dale I -- 31/5/11 . i Continued/Additional Comments by Superintendent/Designate i Dale Ii . [a . . commems_ Signalumi rwng?adio? ch) 30 ?a 07/23)? . I AW W?g??m M?g?m o?z/ in; I 03,08) 1dr ?45Comments'by Regional Director/Designate . i - - Comments Signature: Date i - - i 3.2111) - Distribution: Original - Regional Director (Only for Regional Director Re View) . Copy - Inmate its 080 075-100 (10104) i i 000518 . Central East Correctionai Centre Enmate Submleelon for ?30 Day Segregatlon Reviews Inmate Name:_ OTIS NUMber: inmate written for 30 day segregation revlew: "mu: ural aummaswn [or at? segregation '(To be completed by Segregation Manager) _v 1 521(1) Inmatesignaturei Date: Witness N'am?? ?79 FFc'D'ng Witness Signature: 000519 Regional Director Revlew Page 2 Not SUppoded. MA (bomb Continued Swegalion a wponed Comenlsgo - I 4-WNIE Nam/3* vid? ?=LQarmck+u 68W SUPPRMAW Mgr-Jr or Name 09 Regional DireJ?/?eslgnale iPrInl) SlgnalUw of Reqlo?al Dale I QM baur v} Gig/?lial?- SUppleIE?nentary Report for each Subsequent 30 Day Period (use boflom 6! form f; adduionelc'ommenls Commanls I Signalum: - Dala - -l MWde. 8 MAL ContlnuedJAdditional Comments by SUperimendenUDesignate I Commanls Signatura? Dale Ra d) - ?zz - Way/w . 319122. ,4 - la ch) Ao' 07/23/14 20. ham-q,? . . jag; k9? owbg?rlq? J@Ed\wm . \n .- amwd Widen?M: oKII-rsl-Ha ?~rM I QonllnuedlAdditional Comments by Regional ma?a/Designate (. commenls Sign?ure' Oat: . Mde/ym s.21(1) own-325w: Distant (WMWa'adwReHc-u} . Cop-I- Fl. 075.100 (1010?) 000520 L95 ?t '16 District Administrator Review 'Page 2 Continued Segregation Supported Comments 1 Not Supported "Ema ol District AdministratorlDestgnate (Print) Signature oi District Administrator/Designate Date. Supplementary Report for each Subsequent?30 Day Period (us a bottom of form for additional comm Comments Signature Date . . ContinuedlAdditional Comments by Superintendent/Designate Comments Signature Date Wxn'm k6- oq/torllq" Callblilq m3. amt . ?5 s?.NlR c. 14(7)(d) 521(1) Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date angina! - District {Only (or Dist/rot Administrator Rew?ew) Copy - tnrnato Fiio cso 075.190 (1 0104) 000521 moo Pagei Regional Director Review Continued Seqreqalion Commenis a . a ??67t>4n123 Supported Nol Supported Name of Regional Director/Designate (Print) Slgnalure of Regional?oireclorID signals Dale Ga?b?x 10/24/294 I I . Supplementary Report for each Subsequent 30 Day Period (use bottom of form additional comments . Commenls Taryn Date 4 - i if Continued/Additional Comments by Superintendent/Designate Comments - Signature Dale . V'kn. - .4114?, ogligll - Jig M56 . 0812-5~Aoud-cea~J vo unpain? I oq-LOi/I; .9 . I LAJLA 'Sw9.41.. mlogjl ?aunt-vs vwlv?v i I I. ConlinuedIAdditional Commenls by Regional Director/Designate Commenls Signalure' Dale z' . s.21(Dialrlnu lion: Onnlnal - Regional Dlmuor (Oniy lorRagionar Review) Capyv lnmata Filo CSD 075-100 (10100 i I . ,000522 1 fit; I I Ministryomommun'tysafety Segregation Decision/Review 'r?bntario Fired?Tm; institution In! clot!? '1 (?Lyn I VJ Central East Correctional Centre Client Identi?cation No. Name (Lasl, FirstI Middle) Reason(s) for Segregation . I Date of Segregation Protective Custody El Institution Security Medical El inmate Request I . . 23 May 2014 inmate adVised of reason for segregation. - inmale advised of opportunity to make oral or written submissions Inmate advised of opportunliy [or interview with Superintendent inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of Superin? slgnate Date . K. Staffers, com . 9 05-23?2014 Superintendent Decision (This section must be completed Within 5 days of the inmate's placement in segregation) inmate Submission admitted to segregation from amen-end Withdrawal - claims to have panic attaCks and does not get along with others. - I Superintendent Decision . Cl Release from Segregation . Continue Segregation Reasons: I Name ofSuperintendenllDeslgnaie (Print) 7 Signature 'ol SuperintendenUDesignate - Dale 3 I ?0 05/28/2014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission . Superintendent Decision El Release from Segregation Continue Segregation Reasons: 710 . Name of SuperintendenUDeslgnete (Print) Signature of Superlnien .nUpesignate I Date ?mcwuwma . Supplementary Report for each Subsequent 30 Day Period (use reverse ottorm for additional comments} Comments Superintendent/Designate Signature . Dale - - s.NlR 5.21 (1) CSD 075-100 (10/04) 000523 Regional Director Review Page 2 Continued Segregation Not Supported Supported Comme n13 i . Date Name of Regional DirectorIDeslgnale (Print) Signature of Regional Director/Designate Supplementary Report for each Subsequent 30 Day Period (use bottom of fem for additional comments \JJ?riWw awkwI-s-s?t fcge?tv-coL. kt: Vam?ca Grazer. Comments {immature Date I . 06/29/2517" Continued/Additional Comments by Superintendent/Designate 1 Signature Date Comments 0.1: ?5ujo Elmo.? 09/12/294 4.41 25% elm/[i 11L, $3 ecu/2311+ kin G1 How-s Mbw?wh?? car-E). ?3qu Stew Continued/Additional Comments by Regional DirectorlDesignate Comments Signature Date s.Nl 5.21 (1 5.21 Dial?bullon: Original - Rogimal Director (Only for Regional?ireotor?a?aw) Copy - Inmate Ftle cso ans-100 (10/04) 000524 Regional Dir?clor Review Page 2_ Conlinued Segregalion Supporiod No! Supported Comments . Pei-?ax?e' submission-w i Name; ofReglonal Diredormgnale (Pn'nl) Slgnalute ol RegionalWeslgnale Date 67/194206" Supplementary Report for each Subsequent 30 Day Period (use bottom affairs; for addilional comments Commenls Dale: Mdem Wwi?w LeEv-coL - I WignaluraI Q?qquknq5 Vemo?w (M. o? . Continued/Additional Comments by superintendent/Designate Comments . Slgnalum I D7210 - PAde WW 6/L??f 'l . nirT -n.u IIAA AA. I . i Con?uUed/Addiliona! Comments by Raglonal Director/Designate, Commanls Signalum Dale- . s.21(1) . i - Wnuuon: copy-mm F00 I can 075-100 (10104) 000525 Centrai East Correctional Centre inmate Submission for 30 ay Segregation Reviews- i inmate Name:_ OTIS Number: veg-{r . Inmate written submission for 30 day segregation r'eviewz, Inmate Oral Submission for 30 day segregation review:- (To be completed by Segregation Manager) M. GAQM I i?m?Gw?q Inmate signatur?e: Date: 6% l? I Witness Name:- Witness Signature: mt: I 000526 Regional Director Review Page 2 Continued Segregation Comments Supported Not Supported Name of Regional Director/Designate (Print) Signature of Regional DlrectorlDeslgnate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for addt?ona! comments . Comments Signal 6 Date (Dip/2.25? Continued/Additional Comments by SuperintendenUDesignate 34 4o 45? 6'0 Comments Date . T?ka'?k adv/H ob: - Um . 1?0 +041, in - '3 3irt) kw MA. 07} 6? 07/77/14 AW I Mule 9.4an Jan mu; 97uiz~iurlq - 07/9511 ContinuedIAdditional Comments by Regional Director/Designate . Signature Comments Date I 9.21:1) 030 075-100 (10104) Original Regional Director (Only for Regional Director Review) Copy - Inmate Ftte 000527 . Pagez Regional Director Review Conlinued Segregalion Supported - Not Supported Commenls 1 . Name of Reglonai DIreotorlDeslgnale Signalure 0! Regional DirectorIDeslgnale Dale Supplementary Report for each Subsequent 30 DaLPeriOd (use boftom 0mm for additional comments) - Comments nature - Dale . . A 4 - - . 0 9/21/2 - .Fganlinued/Additional Comments by Superintendent/Designate Comments I Slgnalure MMESEW . ?Mung: . . [9(0 dijQ?h??ASk hilly/[LL 2,0 {km ?UL?A?t-Oqi?vxg?l-bw we - I Y/orllu? aqg Vm 52.23 EEMJQEM MN- q??alm in. manAvmwoowJ-LOL . 9w :4551Waived? ?Lb?b? 0 . 64.14.94; 4D xvi) (rid?o - - if?? Ere Continued/Additional Comments by- Regional Director/Designate Comments - Signature . Dale . . I I s.21(1) . 5724135) Dlol?bujlnn: Original - Ramona! Direclor (Gary ror?egkmal mrmor?e New) Copy lnmale File CSD 075-100(10104) - 000528 1' Page 2 Reglonal Direclor?RaViaw Con?nUed Segregation Supponed 7' Not Supported - - Com 3 . I . . gag?A. FA. uLmLoJI?a. nc/OL Name of Regional Direclorlnasl'g?te (P?nl) Signature oi Regional DIredorIDeslgnalo - Date I - ?zjj af/O?flza?r- Sumlamentany Report for each Subsequent 30 Day Period (use bottom 0mm foraddi?onal comments Commenla nalura 035 A r4 MMIndImy of/n?, CnnlinuedIAddiHonalCommeanb Su erlnlende?UDesi nale Commenis Signature 0an . - mun!th hmm'?, . M't - ?aycalm/:4 ?mats-H . . Wm vug?gau "rb a ?sz?Bdagp?hs wwu'n uctaan I g; EWJWJ was aim/L3 are. Q'o Mum?Lu;w 03,21! Conti??ed/Addll?al Comments by Regional Director/designate Comments SlgnaIure Dale 5.4 I (Am) Dlu Vlhullan'. OnghM - Roam! 01:. do! Copy Arm? ?lo 030 075- 00 0/04 1 (1 000529 Regional Director Review Con?rmed Segregation Suppodod Not Supported Page 2 CommentsI 2 Signature oi R?gionali?lrecto Name ofRegional DirectorIDesignate (Print) signals I Date Gear-F bra-m4 Supplemental Report for each Subsequent 30 Day Period ?rse bottom of form for additional commenls . Comments - . "gnalure Dale . 05W Uf/ZZ/gg . I I Continued/Additional Comments by Superintendent/Designate. Commenls . Slgnalure' Dale . I 6 I I ,7 11", . Cam 0+ 0M mg 221*? ?j cilia/t4 I I H0 ?in-wk oqIIll/Il' ts- mw - 1'4 i (P4 ugh-OQIIDZIH ContinLQedlAdditionai??omments by Regional Director/Design . - Comments Signature Dale I MMIdd/yym i 5.21m . I Original Regional Director {Only for Regional?ilatlor Raglan!) Copyv Inmala [-719 CSD 075-100 (10I04) a i. 000530 (O Segregation Decision/Review W4 Ministry of Community'Safety by) . - . and C?o?rraqttonars?ma'?et I In?ow a; Institution Central East-1 Correctionai Centre Name (Last. First. Middle) Reasonts) ler Segregation Client identi?cation No. Dale of Segregation 21 Aug 14 B'Protective Custody D'lnstilutton Security [3 Medical Inmate Request Inmate advised of reason for segregation Inmate advised oi opportunity to make oral or Written submissions Inmate advised of op?muntiy for interview with Superintendent E-lnmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignale (Print) Signature of SUperintendentJDesignaie Date Sgt. Stofiers 22 Aug 14 Superintendent Decision {This section must be compteiad within 5 days of the inmate's placement in segregation) .Inmate Submission . IIM'requesting segregation - claims _he has anxiety issues and cannot be around others - Superintendent Decision Release from Segregation [21 Reasons: detLa_~ia~mL_. Continue Segregation mamas *5 ?m ate?3 Name of Superintendent/Designate (Print) Signature oi lende UDesignale Date 08 )zLi/H' Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) InmatetSubmission t/M Lo Mots-c.? Superintendent Decision Release from Segregation Continue Segregation Reasons: L- I Name of SuperintendentlDesignale (Print) Signature of Superinte Igna Date /o I Supplementary Report for each'Subsequent 30 Day Period (use reverse orrorm foradditionaicomments?) Comments Superintendent/Designate Signature I Date - I s.14(2ttdi s.21(1) (:30 075?100 (10/04) 000531 I6 3.0 36 (R4151 . 0 o1?? Regional Director Review - Continued Segregation Supported Not Suppo?ed Page 2 Comments 30 Li I Name of Regionai Director/Designate (Print) I ?oaq??yc? Signature of Regional DirectorlDesign'ale ?26,246? Date fa/M zory I Supplementary Report for each Subsequent 30 Day Period (use bottom of for for additional comments Comments A [signature I - Date 0?772 2/265 Continued/Additional Comments by Superintendent/Designate . Comments Signature Date a A. ?lm Clay?s? camava Va! 0*7/0 we a ?Q/r Jr?s? Sm . Jat! unmet gage/kw @3 69/10/19; 1 . \jm "t?an?tM ,Amm? Mimkxk NW.- A opt-15 Oct/3v)? Continued/Additional Comments by Eggional Director/Designate Comments Signature Date 521(1) . Distribution: Original - Regional Director (Only (or Regional Director Review} Copy -'tnrnato file ceo 075-100 (110104} 000532 - . Ministry ?Community Safety Segregation Decision/Review - and Correctional Services Ontario ?Centrai East Correctional Centre Name (Last, First. Middle) ?1 Client Identi?cation hie. _neasont5) tor Segregation Data at Segregation - - -- 24 Aug 14 Protective Custody Institution Seourtty Medical inmate Request Inmate advised of reason for segregation - Inmate advised of opportunity to make oral or written submissions inmate advised of opportunity. tor interview with Superintendent inmate waives opponugltyelor?interview with Superintendent Name at SuperintendenlfDesignate (Print) Signature oi Superlnlend esi nete Date Sgt._ K. St'ofters - i. 01 Sept 14 Superintendent Decision This section must be completed within 5 days of the Inmate's placement in segregation) Inmate Submission admitted from 4 pod - tears for safety Superintendent Decision El Release from Segregation Kt Continue Segregation Reasons: Name of Superintendent/Designate (Print) - 1 Signature oi Su erinlendenUDesignale Date 09/01/14 Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission . Sgperinlendent Decision Release from Segregation Continue Segregation Reasons: Name of SuperintendenUDesignate (Print) Signature of 8 pa entIDeslgnate Dale . - era/0511+ SUpplementary Report for each Subsequent 30 Day Period (use reverse ottomr tor additionatoomments) I . - Comments Superintendent/Designate Signature Date . . s.14(2ltdi s.21(1) cso 075-100 (1 0104) 000533 Regional Director Review Page 2 Continued Segregation [3 Supported [j . A Commentsgo - EutE-m 55.54%. gnaw ?Amt W, Magi 969*ch :nmCL'k'g Not Supported 90L Name of RegionaMiredorlDasignate (Print) ?1 flu-1c- Signature of Reslonal DtrectorlDasignate Data at )a?/zots? Supplementary Report for each Subsequent 30 Day Period (use bottom of fo??'or eyditiqgalparnments Comments me Date 30 MMIddInw 5,1 . Continued/Additional Comments by SuperintendenUDesignate . Pomments Signature - Dale 0 WW I ?Rn?m 3m Uta/Kg we cells/1+ mmxud? X?o WILM 09/21/ng Lama QM. er to . KW 09/94in (meuezs. gawk - . ContinuedlAdditional Comments by RQgionaI DirectorlDeslgnele I Date Copy - Inmate File 080 075-100 (1 0104) - Comments Signature 3 5.21 (1 A otsulbuuon; 059ml.an 000534 u" I - [y MWSW ?f ?mm-?W Safety Segregation Decision/Review Ontario and CorrF?'t'lo'E?aITSE'r??esl? . .Central East Correctional Centre I Name (Last. First, Middle) CliWi?catlon Reason(s) for Segregation . Dale ol Segregation [j Protective Custody Institution Security Medical 'lnrnale Request 26 AUQ 14 lnrnale advised ol?reason for segregation I Inmate advised of opportunity to make oral or written submissions Inmate advised of opportunliy for Interview with SUperintendent inmate waives opportunity tor interview with Superintendent Name at Superintendent/Deslgnate (Print) Signature olSuperl te lgnale Date . Sgt. K. Staffers - 01 Sept 14 Superintendent Decrsron (This section must be completed withln 5 days of the inmate?s placement In segregation) Inmate Submisston l/M displaying unusual, and bizarre behaviour Superintendent Declslon' CI Release from Segregation K4 Continue Segregation Reasons~Name of SUperlnlendenUDesignate (Print) Signature of ndenUDesignate Dale - - [r 4? Segregation Revrew (Inmate?s segregation to be mwewed every 5 days. lnlerwew inmate to be conducted every 30 days) inmate . In wt. 2 at Superintendent Decision El Release from Segregation 3 Continue Segregation Reasons: 5 Key- Name ofSuperintendenUDeslgnate (Print) - SigWrIntendent/Deslgnate Date I I 3 can/057M I?tppleme'ntary Report for each Subsequent 30 Day Period (use reverse offarm ror additional'comments} Comments SuperintendenUDeslgnate Signature Date . . . - 21(1) 0er 075-100 (mm) 000535 Regional Director Review Page 2- El Conlinuod Segregalion 13 Not Supponed . mi? . new :i1 we ?en-awe cheek Derm?u?hf?fL?FESD Suppo?ed Common?:ng Name ol Regional DirectorlDesignate bat-(ml: Signalure ol Regional DirectorfDesignala Dale {14/20 lkf. 6429? Supplementary Report for each Subsequent 30 Day Period (use bollomm?r or?onal comments Comments W4 ?9qu Mb mow}; Dale an 9 hrs/x4 (if/A0 .w ?ockaVRO -i be Jaw-L . Continued/Additional Comments by?SuperintendenUDesignate . Commenls Slgnalure: Dale . . L?wu?iu? 1/ i '7 aw/JL loci/?ol/I 4 WR-gb?wakna?xm?ms-?M ,umy m/iu/I?F 5 Mu? E: ?3:41. Wm - LE, Fwd?. . coho/1+- Le. ??vme 9\ ?5?.qu 09/26/14 Continued/Additional Comments by Regional Director/Designate Comments Signature: Dale . I I 3.21 Disl?nullon: Original . Regional 0mm: for Regions: mean! Review) Copy - lrmale File 1 CSD 075-100 (10(04) 000536 Mitt}!th ofgomr'nsunliiltcsi?ifetv Segregation Bootsoanevrew . - an orrectona erv ea ., 5 Ontario ?ea??x i i of Central East Correctional Centre PM Name (Last. First. Middle) c3 Client identi?cation No. . I - - Heasonm) Segregation - i Date of Segregation Protective Custody, El Institution Security Ci Medical Inmate Request 25 um 14 i - Inmate advised of reason for segregation Inmate advised of opportunity to make oral or Written submissions inmate advised of opportunity for Interview with Superintendent i2 Inmate waives opponUnily for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature 7upe enUDe 'gnete . Date . Sgt. Storiers 04 Aug 14 - . Superintendent Decision (This Section must be completed within 5 days ofthe inmate?s placement in segregation} Inmate Submission . Admitted to segregation due to erratic and bizarre behaviour. Superintendent Decision Ci Reieaseirom Segregation 8 Continue Segregation Reasons: - LN - at a (?QLM-nv-wa?b? d-v-?ES 1m I mi) \thMx-oxsk?q?f: pod LEM . . . Name of SuperintendenUDesignale (Print) Signature of So e' ignale Dale M. Sire. :3 r; ?arcs-t, I 08/04/2014 Segregation Review (Inmate's segregationto be reviewed every 5 days. Interview with Inmate to be our duo-(dd every 30 days) inmate Submission Ll Lo Van/Beng- I - i Superintendent Decision Cl Release from Segregation I Continue Segregation nge-N: ?arem-QL. . i Name of SuperintendenllDeslgnate (Print) - Signature wdenwesignale Date Swot-"Cm . C?m\ I i 08/155,120? Supplementa4ry Report for each Subsequent 30 Day Period (use reverse offarm i Comments Superintendent/Designate Signature . Date i I a i 21 t1) :80 075-100 (10t04) 000537 Regional Director Review -Page2 i I i a Continued Segregation El Supponed Supported Comments i . . . Name of Regional DirectorIDesignate (Print) Signature of Reglonal Director/Designate Date - - i Supplementary Report for each Subsequent 30 Day Period (use bottomr additional comments Comments lure] Date - (am/m . . i I I Continued/Additional Comments by SuperintendenUDequnate I . Comments Slgnalure' Date MEL: 9'0 La.? . hawt?~dx?9aq3r~3?w~ 8 km a 535" a4J%45tact-vs 104*?4 nun pvmtidahu . a. L??d?cu?u3 MAL Jca Mm rehab. . ?w - . oe/gqj/Lf Continued/AdditionalComments by Regional Director/Designate . i . Comments Signature: Date 3-14i2iid) 521(1) CSD 075-100 (10/04) Distribution: Ortng - Regional Director forRegbna! We Review) Copy - Int-hale ile 000538 Page 2 Ramonaloirecwr Review 1 . i Conlinued Segtagal on Supgorlad EL [40133911on Commenls a. J: h??'mvc' I Nar'ne of Regional Dlteclorloesignale (Purl) Signelure ol Regional blrecl0?naa nale Dale Sugplemenlary Raporl for each Subsequanl 80 Day Period (use bollomaddhlonal comments I . Commanls lurof - Dale A 1 43; #dedlm Wm: a ska/2w 0 - a ConlinuedlAddi?onaI Comment-a bISUpefinlendenUDesignate Commonly Slgnalum Date - ~1de W- L-P A ?L??Mqi-Bc?wam dun?lm 91.9 ax aw?; yd? hub 00-1 - Laws": 994 {Au-b Mesh EL Ough- . . - 03/24/2tf - I i Comments by Regional DireclorlDesignale . . Comm?nls - Signalure' Dale MWde i I S.NIR 321(1) i ah?thq-lom 0mm - Hogan-u! Dime! (any Mara/Rome copy-Inmlo I-?a?tu 050 075.100 (10/04) i . g' - 000539 Regional Director Review Continued Segregation Comments? EH Bianca bJ-Oq??ww Supported Not Supponed .Dm?t?Qo. +e wa?zwii'ieei Page 2 Name at Regional Director/Designate (Print) A @083 ?fth-K Signature of R?ginnai ?9776 Director/Designate Data 20/9? I . SupplementeBLReport for each Subsequent 30 Day Period (use bottom of form/r'grg/q/q/itionat comments Comments (or 6 A Date J1mqu +0 china mqguaodag?w.wo 5L VuP/rmab 417% ox, Siam If 14(2) [3 I JUL-LC) rrW-J?Ol Uh - Continued/Additional Comments by Superintendent/Designate Comments Signature Date . Mdeer 13?me1?, 5:54.45? - -, - o3 23[/ cf 8% . Bim Wtoww midis? [cu-.1 inw ?2 Iii/x4} we. zierFau/b -- 9 loathe/1'4 EAL-let." . ym com-\Anwa LC) -dgikt?3ka}u 6% b?x'boardc \mhb ed Wlm-?u?m cw ngb?o Qpro 9?81.er - O?i/ZLfI/l?r? Continued/Additional Comments by Regional Director/Designat Comments Si?nature'l Date 521(1) O?glnal . Regtonal Dlrector (Only (or Regional Diractnr Raview) Copy- Inmate Fire (:50 075100 (10104) I 000540 semen -.. .I . i Ontario I Ministry of Comrfiunity Safety Segregation Decision/Rewew. and Correctional Services 5-5 Client Identi?cation No. Name (Last. First. Middle) I Gentral East Correcti? Reason(s) for Segregation i:i Protective Custody Institution Security Ci Medicai Inmate Request of Segregation 31 Aug 14 Inmate advised of reason for segregation Inmate advised of opponun?ity to make oral or written submissions - inmate advised of opportuntiv for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendentiDesignate (Print) Signature of Superintendent/Designate Date Sgt. K. Stofiers i 01 Sept 14 . 7 . Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission . l/M admitted due to bizarre and unusual behaviour SUperintendent Decision [3 Release from Segregation E4 Continue Segregation Reasons: - (Unau? (Liza-?fta c'sr-rcaVi-Sc-B - - . big LAN. . 03 bu -. Name of Superintendent/Designate (Print) Date Signature of Superinterw Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission 'Q?we? is: st agents; to [Lasso/<2. Superintendent Decision i:i Release from Segregation Continue Segregation Reasons('65 5 I - I Name of SupermtendenUDesignate (Print) Signature of SUWME Date 09/!0Supplementary Report for each Subsequent 30 Day Period (use reverse offomt foradditienal'comments) Comments SuperintendentJDesignate Signature Date s.NlR (521(1) I CSD (10/04) - 000541 a Regional Director Review Page 2 Continued Segregation 48'" Suppoded Not Supported . . Name of Regional Directm/Designw l?f Comments ?i?f/M a; 3C: {614% a, Mm'?n (5 A {?iscewtucfrv 941:3. Signat Regional Director/Designate . ll Dale Supplemeptai?eport I comments Momments . fg?KeaeKSubseguenl 30% Period,(use botto Date [fir/3'? away?, I Of/?fo? wt; Continued/Additional Comments by Superintendent/Designate Comments Signature; Date - . - . . few-meg would OWN k1 it"i I e" d? Bawom. 5:we?: own-s ?w?s i QengM(v 3) I . i (As: 15 1% oquf/I?JA . 9g kkau?t'owv ?en-N con-"c- I mew?RM .I Continued/Additional Comments by Regional Director/D?ignate . - Comments Signature Date . 0 VM ??5.35 kaA Vs . noun 4'0 \ov: Pit-Vick \xo?h P. meoc cc; *rs?oc; a? .9;ch . ?chcuxoL 3.6! o-??oii. cacao/K Seiko-AA au-N - A lsr? . i ?ck, c(aging! - Ragiogal (Only ror RegionnlDireclor Revian b-NiR . .. opy - Inmate Flla we: 00% .22.. 533;?) . . 5. 000542 by 1' Mimsw safety . Segregation Decision/Review - . - and Correctional Services. - . I ontariQiInstitution Ottawa-Carleton Dentetion Centre Name (Last. First. Middle) 7 . . Ciienl identi?cation No. Reasonts) for Segregation Data at Segregation Protective Custody %tiiulion Security Medical El Inmate Request - 091010014 0.- _D-lnmale advised otreaeon for segregation - Mate advised of opportunity to make oral or written submissions [Tri?es advised of opportuniiy fer'inlewlewrwith Superintendent . Ci Inmate waives opportunity for Interview with Superintendent if}: 7* Name of SuperintendenUDesignate (Print) Signature of Superintendent/Designate Dale "$th - . I 09/01/2014 . Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) . I 'Inmaie Submission 9? Superintendent Decision El Release from Segregation Continue Seg?a?on Reasons: I 7 Admitted to Seg forz: Name I Signature ofSuperl ndenilDesignate Date 'Pat Barnes. NDeputy Superintendent -i 09/02/2014 . . . I Seg?gatlon Revrew (inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission Superintendent Decision - Release from Segregation . Continue Segregation Reasons: . . DAY: . 0 ct 4\ - Naw?ol uperlntendenUDeeignate (Print) Signature ofSuperintendenUDesignate - Dale - i 9" b' Supplementary Report for each Subsequent 30 Day Period (use reverse ottarm for additional comments) Comments - SuperintendenUDeslgnate Signature Date . . -- '54 [4 I I I cso 075-100 (10104) 000543 ~ZF>Ontario - Ottawa-Carleton Detention Centre INMATE SUBMISSION 30 DAY SE-GREGATION REVIEWS Inmate Name:_ OTIS Number; Inmate written Submission for 30 day segregation review: I s.21(1) .21 2 Inmate Oral Submission for 30 day Segregation Review: a 5 I. I (To. be cOmpieted by Sergeant) inmate Signature: Date: /7 Witness Name: [Mi Witness Signature: ?000544 . I . I Pegez ?Regional Director Review 4_ Contlnued Segregation IE, Supporled NolSuppo?ed Commenls A?Lfm Name of Regional DirectorIDasignale (Prinl) 7 of Reglonai DIreclorlDeelgnale Dale bah-:3 ?ka?A had/M, Sgg'plementary Report for each Subse?enl 30 Day Period (use bottom of form for additional comments Comments Signature Dale ConiinuedlAdditionai Comments gy SuperintendentlDesignaie . . Comments - Signature Dale IDS. fi?(ubingiwtrg Una/1+ . a \wAwart. 1/1 15C) - Uv?/xg' LJ :11? 40 7 may?) \wumk Leak I I jI- fir/EL Continued/Additional Comments QLRegionai Director/Deslmat . Cpmmenla . Signalure - Date (D Mn PILL hiya/0g -I g/g4W/fi/S7gy Dial?bullon: onginal - Regional Dime! (Only IarReybnalbiradarRaricw) Copy lnmale File 1 . s.21(1) I 000545 050 075?100 (1 0104) sesame Ontario Ministry of Community Saf and Correctional Services egregation Dec i'sioaneview tms?uhtunmt Name (Last. First, Middle) Client Identi?cation No. - tor segregation Instit ttawa?Carteton Dentetion tre Protective Custody Ci institution Securtlg medical Inmate'Requesi Date oi Segregation 08/29/2014 Em advised 0! reason tor segregation inmate adulsed of opportuntiy for interview with Superintendent Bn??te advised of opportunity to me I or written submissions waives opportunin for in erview with perintendenl Name at SuperintendenyDosignete (Print) Signatur of Dale - 4 (4.4 I 08/29/2014 . - . Superintendent Decision (This section must be completed within 5 deg! ipngm??piecement in segregation) inmate Submission . Superintendent Decision Ci Release from Segregation ContinuevSegregation Reasons: - Admitted?to Seg for: 5 Name ofSuperinlen entiDesignale (Print). Signature fSup 'nlen'dentlDes' nets Date fa 7144. - - 03,3090? 1/ VV Se re altion Review (inmate's segregatianta inmate Submission Jigs. be reviewed every 5 days. we iew with inmate to be conducts dr?very 30 days} Supertntendenl Decision Ci - Release from Segregation - 13" Continue Segregation Rees at; We) OBS Name of St: erinlendentiDesignete (Print) Wmuperintenden gnate Dale . Supplementary Report for each Subsequent 30 Day Period (A: revmfform for additiona/icomments) Comments SuperintendenllDesignale Signature Date I 321(1) CSD 075-100 (10104) 000546 LII letJJil" Page 2 I Regional Director Review I i Continued Segregation Supponed El Not Supgorted Comments . I ?iz?vc" I Name of Regional DlrectorlDesignate - I Signature of Regional Director/Designate Dale The??u (Yb arr/1% Supplementary Room for each Subsequent 30 Day Period (use bottom of form for additional comments - Comments Signature - Date Continued/Additional Comments by Superintendent/Designate Comments . . Slgnature Date a. mi do/Mm we I of "Ii/0' an I ?5 I (d 7-H (Li! I I 3 521(1) . ED I /7 S?s Ceca?ts. WES - a Hum"); I QD . Vl-I?vili Continued/Additional Comments b1 Regional Director/Designate . Comments Slgnature Date - . 2414 MW) WA 1 A ./?2Ez?221 E??Mix @M/am? 1/ - a I - 44924" [42' 444% 4% 1401/ 37/20/?/ 075100 (10104) 000547 in; i - A . - Ontario Ottawa-Carleton Detention Centre SUBMISSION FOR so DAEGREGATION REVIEWS inmate OTIS Number: Inmate written submission for 30 day segregation review: inmate. Oral Submission for 30 day Segregation Review: (To be completed by Sergeanti Date: inm'ate - Witness Name: Witness Signature: s.21(1) 000548 Ontario Segregation Decision/Review 1 103.4104 LI SUI I ii ulion KOCDC Name (Last, First. Middle) ?N?mnqneuogo. "Reason(3) iorSegregailon 7 Protective Custody I: Institution Securltj Medical Inmate Request Dale of Segregatlon 09f27l201 4 Inmate advised of reason for segregation - inmate advised 'of opportunity tor Inte?lew with Superintendent inmate advised of opportunity to make submissions inmate waiVee? opportunity for interview with SUperiniendent Aimee M6. - Name or SUperintendenUDes'lgnele (Print) Signaiwzwe?gnaie Date Spike SGT - 09-27-2014 Superintendent Decision (This section must be completed within 5 days or the inmarqe?gam in segregation) inmate Submission - Superintendent Decision El Release from Semegaiion Continue Segregation Reasons: Suicide Watch Name of Superlniendenlioesignale (Print) Date SiganeriW . {44.4 Segregation Review (inmate?s segregation to be reviewed every 5 days. inlaian inmate to be conducted every sci-days) 29-? we}; Inmate Submission ll Superintendent Decision Cl Reasons: ema?e Mu Release from SegregaiiWominue Segregation - - w/ Name of Superintendenlloeeignaie (Print) SignaWrwrintm Date Alli/ll 9" (Lt . I Supplementary Report for each Subsequent 30 Day Perrod (use rave 3 ram roraddirr?onar mmenl?) Comments SuperintendenUDesignate Signature Date 5.2?ri? (330 .075-100 (10I04) 000549 . P) . I Ontario Ottawa-Carleto'n Detention Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:__ OTIS Number:__ . . . . Inmate written submissmn for 30 day segregation revuew: - I s.21(1) lhmete Oral Submission for 30 day Segregation Review: -: (To be completed by Sergeant) I Date: ??aley- ?Inm?ate Sign?ature: - Witness Nam-?? ?7,er a Witness Signam_ 000550 Page 2 - Regional D-ireotor Review Continued Segregation 13/ Supported Not Supported Comments I Name of Reglonat DirectoriDestgnale (Print) Signature of Regional DirectorIDestgnate Dale awe MM . arW/V SupplementaerReport for each Subsequent 30 Day Period juse bottom of form for additional comments Comments Signature Date mulletde ContinuedIAddltional Comments 9y Superintendent/Designate Comments Signature Dale 3C Lb l? ?10 I LL ?ls/I {pug/y ".03 . \mw lie." - 55 . Vim M?Qd?l' bar; I - [Alla/(j/ L19 7 [Iii-2.441% Comments bLRe?onal DlrectorIDeslgnate - - - 7 Comments - Signature Dale \d do 521(1)? 000551 ?EzEmEinmmt! Segregation DecisiOn/Rev'iew Ontario lugs/on u~o~r . ii ocn'c? Name(Last.Firsl.Middie) . - - Ciientidontlfi tIonN . ror segregation Date of Segregation Protective Custody Security . Medical Inmate Request 03 Juw 2014 ~_lnmaie advised oi reason for segregalion Inmate advised of opponuniiy to make oral or written submissions Inmate. advised of opportuntly for interview with Superintendent inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Prinl) Dale e; Superlntenden signale 1c] urmJ? bros July 2014 i . Superintendent Decision (This section must be completed within 5 days of the inmate?s pieceme Mgmgeiion) inmaleSubmission . 7 'i 3/ SuperintendenlDeclsion Release from Segregation iD-l Conlinue Segregation Reasons: . i I SUICIDFPL 1 I re oi Superlnt Name OEWdenUDesignaernnPE Dale - ?trim: UME \in 07?0443 Segregation Review (inmate's segregation to be reviewed every 5 days. inierview with inmate to acted every 30 days) inmate Submission i Superintendent Decision Release from Segregation Continue Segregation Reasons: - me (Cd Obserum?won NawmenUngnate RR Signal of Superint Date I V, - I ?i UHLQ it 0750:? "i Supplementary Report toreach Subsequent 30 Day Period (useievarsa ofrorm rcira mmanis) . . Commenls Supe?niendenUDesignale Signature Dale 5.42111; ?iD 075-100 (10/04) 000552 lnm?ate Signature:? be . 1.. Ontario, Ottawa-Carleton Detention Centre FOR 30 DAY SE-GREGATION REVIEWS Inmate Name:_ OTIS Number:_ Inmate written submission for 30 day segregation review: s.21(1) Inmate Oral Submission for 30 day Segregation Review: I (To be completed by Sergeant) Date: 9g '4 Eula-25.5% Witness Name;- a; Witness SignaTUl'e: 000553 Page 2 Regional Director Review .. Con?nued Segregatlon EV Supperted No! Supgorled Comments . Name Of Regional DirectorlDeslgnale (Print) Signeluro of Reglonal DirectorIDeeignalge I Dale Supplemento Repon for each Subsequent 30 Dgy Period (use bottom of form for additional comments) Comments Signature Date - . 1 4(1 521(1) I I Comments by Sggerintendenuoesignate Commenle . Signature . Mwa?gnm [25 um 11/ \36? lulu?; ,1 13$ . iwk? ll 1/4 No via?Rig;wa how-?) - I no? H5 jb mm, [MU/sub mgr/13. 6 0- JED hut; uM-t. . Comments by Regional Director/Designate Commenls . Signature Date . . 11/11441% [Kiwi tog WWI file/Isl . Olsmnuuon: Dogma! - Regional Dhaolor (Only for Rogbnal Mada! cw I I Copy-hmaleF?e CSD 075-100(10104) 000554 ?anenmmrami Ministry of Community Safety and Correctional Services - Ontario Segregation Decision/Review tawa-Carieton Dentetion Centre Flame (Last. First. Middle) Ciiem??n?MQ?d/ ,Reasonts) tor segregation - Datel'oi Segregation Ftrotective Custody mtution Security Medicsi Inmate Request 03,26,2014 E?I?mete advised of reason for segregation E?Tnmate advised of opportunity to make oral or written submissions high/mate advised of opportunliy tor Interview with Superintendent Inmate waives opponunljr for interview with Superintendent Name of SuperintendentiDesignete (Print) Signature of SuperintendenUDesignate Date Pat Barnes. AIDeputy Superintendent 08/26/2014 Superintendent Decision (This section must be completed within 5 days of the Inmate's ptecerrtent in segregatiogL inmate Submission . A Superintendent Decision Release from Segregation Continue Segregaiion Reasons: I . I . I Admitted to Seg for. get?, M?[k S7 (144,760 - (?ows 9c? I Name of SuperintendentIDesignate (Print) Signatur erintendentIDesignale Date Pat Barnes, AIDeputy Superintendent 03/27/2014 Segregation Review (inmate's segregation to be reviewed every 5 cLays. Interview with Inmate to be conducted every 30 days}- inmate Submission - . Superintendent Decision Release trom Segregation Continue Segregation Reasons: A - go Name of Superintendent/Designate (Print) Signature wwn?e Date ?erce: wt Supplementary Report 'for each Subsequent 30 Day Period (use rowerse offonn for additional comments) Comments SuperintendenUDesignate Signature Date . SNIR 5.1 s.21(1) 030 075-100 (10I04) 000555 .. {xv a . .Z'ROntario Ottawa~Carieto_n_Qetention Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:_ OTIS Number:? Inmate written Submission for 30day segregation review: i 521(1) Inmate. Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) lnm'ate Date: Witness Name: - Witness Signature: 000556 4 .- Regional DirelclorReview 7 Page 2 .Conlinued Segregalion Not Suggoned . Maya/C, . 6M7) ?sze?djj Name of Regional leeotorlDesignale 'cso 675100 (10:04) 521(1) Signature of Regional DirectorlDesignale Date ?De/m .- Supplementa? Rejgort for each Subsequent 30 Day Period (use bottom of form far additional comments I Comments - Signature Dale MMIdd/ym Continued/Additional Comrhehts by SUperintendenf/Desigriate . Comments Slgnalure Date f/"lkl' lg 0n: 9213 Con?nuedlAdditional Comments by Regional Director/Designate Comments Slgnalure'; Date . [44.1 114/ f2) Ag, La @5445 Lu; VLMJ fM??i, I i . 2 . ?214 a A $431512? "a [km A . . 000557 a a if Ontario 5 1 Segregation Decision/Review - - i 0qu Middle) - No. Rea 50n(s) for Segregation -. Data of Segregation . . . m6~3_ ?g 24 Sept2014 Proteciive CusiOJd Institution Secruny Medical Inmate Request nmato advised of reason [or segregation Inmate advised of opponunliy to make oral or written submissions I - - I Inmate advised 0! opportunliy for inton'IIew with Superintendent CI Inmate waives Interview with Su ertntendent Name of Superintendentloesinalo (Print) Signature of Su 3 en' la Date Plouffe 24 Sap} 2014 Mniend?nl Decision (This section must be caanIeied within 5 dam)! the in/mate?s piel em?n?in segregation) I - Inmate Submission Su ngniendent Decision Release from Segregation a? Conlinue Segregation Highs: . I .- Name of SuperintendenUDesig'nate (Print) SigWupernimden ?slgnale Dam I 5 ,1 444314] . Se re atton Review (Inmate's sggre?elion in be lavish/ed evegg 5 days. Inie iewlfh inm is to be We?; JO days) Inmate Submission . sugarintendent Decision i] Release from Segregation Continue ?ngation Reasons: ODS . Name ofSuperintendenUDesignate (Print). SignW?ntendenUDas nata Date Alli/11 I 2' - vwva? supplemente?Report for each Subsequant 30 Del Period lass revor? of additionarcou?nis) Comments Signature Date . Nide ?7.21 (1 050 015100 (10/05) 000558 0 - 'a 5/7 Ontario I Qttawa?Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SEGREGATION REVIEWS inmate Name: OTIS Number:__- inmate written submission for 30 day segregation review: Inmate. Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) . i inmate Signature Date: Witness Name:_ 7 Witness Signet re: - s.21(1) 000559 Page 2 Re ional Director Review - Conlinued Segregation Supported NolSugported- Comments ?dd/Mg [if {fr-06 umM cm . 40(94/hl4n4 Moon-I.? Name of Regional Dlractorlbeslgnale (Print) Signature of Regional DlreaorIDesignate Date "Ad/rug I ?ew my Supplementary Ram'th for each Subsequent 30 Day Period {use bottom of form for additional comments I Comments Signature Date Mlde ContlnuedIAdoilional Comments by Superintendent/Designate Comments Signature Date 35/ 0?0: Vb Info] 0135 - was I MD 655 [ml- -. 1/ Wu wt .57" l/r/E'lkl sf oil/3&- 1g elbf (no (Db-5 ""1343 Continued/Additional Regional DirectorIDeslgnate Comments . - - Signature Dale J75): MM 151/94??! i?dzmiw?- i Vim gai/ ii- Blsn'lbullon: Onginal - Regional Director (Only {orme Dh-acmr?ovlew) 1? Copy - Inmate Fllo CSDV 075-100(10104) 5.21 (1) 000560 ?Hammer . Ontario Ministry of Community Safety and Correctional Services - Segregation Decision/Review guano-1L4 institution Ottawa-Carleton Dentetion Centre Wamef?ast. First; Middle) Client Idenli?tion No. 35mm for Segregation Protective Custody Security Medical El inmate Request Date of Segregation 06-10-201 3 A 96mins advised of reason for segregation grate advised of opportunity to make orator written submissions Inmate waives opportunity tor interview with Superintendent inmate advised of opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of ?nten Uesignate Date Francis Noiet. Deputy Superintendent 06-10?2013 Superintendent Decision (This section must be completed within 5 days of (he inmate's placement in segregation) Inmate Submission . . . Superintendent Decision Release from Segregation Continue Segregation Reasons: - Admitted to Bag for: security concerns - Name of SuperintendenUDeslgnale (Print) Signature Weignate Dale . Francis Nolet.? Deputy Superintendent - I 4 Vi Id. . r/ inmate Submission Segregation Review (inmate's segregation to be reviewed every 5 days. intennew with inmate to be conducted every 30 days) Superintendent Decision Release from mgation Continue Segregation . Reasons: DAY: 5 Seems?? Name of SuperintendentlDesignale (Print) (Elna/a. Date Signature of Sn intendenUDesignate - Supplementary Report for each Subsequent 30 Day Period use reverse arrorm I Comments Date 3.21 (1 cso 075-100 (10104) 00056i - I 'Ontario? Ottawa-Carleton Detention Centre SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Namet'_ OTIS Number:_ Inmate Written submission for 30 day segregation review: inmate. Oral Submission for 30 day Segregation Review: (Tobe completed by Sergeant) lnm?ate? Signature - Date: Witness Name: Witness Signature: SAHR s.21(1) 000562 . I - . . Page 2 Regionai Director Review . J. . Continued Segregation Supmned CI Not Suggerted - Comments . . Name of Regional DirectorIDesignaLe (Print) . Signatune of Regional DirectorlDesignate .Dale f8: ZY/z/?c/ ?pplemenlary Report for each Subseguent30 Day Period {use bottom of form for additional comments Comments Signature Date . Continued/Additional Comments Qy SuperintendentlDesignate Comments I I Signature Date . 5?15? [Wild ?_?zauwu_L 7??i/7 5?24) W?Cu?nlm \mei vaA ?gawk Alb/V . . -t 555 ins/ngas hum? mi s?wv? /7 539 mag-m 1mm mf- "Sawing - w? aw.sz . ContinuedIAdditiona Comments gRegional DirectorIDesi nate Comments - Signalure Dale - WI gu?m?wiwja?g 9P Axe Mil? . jw-immg ?4 Law I I 4' 14,, euzmmg ma?- MM . I?/Zg/z?I/r' Dlaltlbutlon: Original - Heglon? Oitedcr {Only for opium: may RFwa - Capy - hauls-Filo . NI 5.1 CSD 075-1001111104) 521(1) 000563 I FAKE Segregation Decision/Review Ontario Ina? 'n I 7 0000 i Name (Last. First. Middle) Client Identi?cation ?R6390h(5) for Segregation 50 6 L, gelleooits?igrfgetion Protective Custody Institution Security El Medical Inmate Request 0 Inmate advised oi reason tor segregation inmate advised of opportunity to make orei or Written submissions E?Inmate advised of opportuntiy Ior interview with Superintendent inmate waives opportunity for Interview with Superintendent Name of Superintendenuoesignate (Print) Signature of Superi Date 21 Oct 2014 - - i it Superintendent Decision (This section must be completed within 5 days orihe Inmate's p! cement I egregatian) Inmate Submission Superintendent Decision Release from Segregation Continue'SegLegation Reasons: I . - Name fSupennlendenUDesignele (Print) ure Superintendent/D signate - Date /0 ?z Ir /r Segregation Review (in ate's segregation to be reviewed every 5 days. niervigvr?iih inmate to be coEcted every 30 days) Inmate Submission . Superintendent Deeision Release from Segregation (KI Continue Segregation Reasons: 5 abs- Nan/121 (Print) . . .Signattl oi upe?ntendenmw Date - ,1 41,904?. km (Dias 14mm Supplementary Report for each Subsequent Day Period (use rip/arse ofform rar additionaim ants) Comments I . {/SUperintendentIDeeignate Signature . Date A . . s.NlR - s.21(1) (:30 075-100 (10104) 000564 0' Ontario 'e Ottawa-Carleton Detention Centre 30 DAY REVIEWS . Inmate Name:__ OTIS Number:__ 7 Inmate written fer 30 day segregatien review: stN/R s.21(1) Inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) Inmate Signature:l WitnessName: Date: ,Wltness, Signaturez?/ . 000565 - Page 2 Regional Director Review Continued Segregation Supported . Not Supported Comments . - ?if . . Name of Regional DtrectorlDesignale (Print) Signature of Regional DirectorIDeelgnala Date Syplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments - Signature Date NIde - Continued/Additional Comments by SuperintendenUDequnate Comments - Signature Date - MMIddImryr Il/ Ii each/(Nana {32/ neva '40? i P?okLe/A?q . ?7 Continued/Additional Comments byjeggnal Director/Designate - Comments Signature Dale 030 0754100 (10/04) .. DIaMbLIllurl: Original-Regional Director -- . Copy- Mate Fl! 000566 ?amaze? mi . . Ontario Segregation Decision/Review, inE-?t Qvi L4 ~Oi on OCDC Name (Last. First, Middle) . No- _Reason(s) for Segregation Protective Custody Institution Snow Medical Inmate Request Date of Segregation 23 Aug 2014 4.. Inmate adirised of_ reason for segregation El Inmate advised of opponuniiy for interview with Superintendent I inmate advised of opportunity to make are! or written submissions -. inmate waives opportunity for?intenriew with Superintendent Name of wnnlendenuoesignaie (Print) Signature of r' entID te - I Date [c941 ff? - 23 Aug 2014 Superintendent Decision (This section must be completed within 5 days of the inmate's pia?men?in?egre?guan) inmate Submission - Stgeriniendent Decision J: Release from Segregation Ci" Continue-Segregation Reasons: - 0 km Valuer?? 1 Date -7 .., In . A A segregation Review (inmate's segregation in be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission of Superintendent Decision CI Release from SggLegaiian Reagons: oan'r I Continue Segregation Name of SupenntentienUDeaignate (Print) Signature of Supe Date s9 - 9 s7 1 Le Sgppiemeniary Report for each Subsequent 30 Day Period (use reverse arrorm rer additionaroommenrs) A Comments SuperintendenUDesignale Signature Date - . s.21(1) 7? . (10104) 000567 . Ontario,? ?OttawavCarleton Detentioanentre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Name:_ OTIS Inmate for 30 daysegregation. review: Inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) - Inmate Signatur Witness Name: 521(1) - 000568 . Pagez Rigional Director Review Continued Segreggiion Sugporied Er Nol Supported um i mans 6rd Aim d?A-ng Name of Regional DireciorIDesignete (Pn'ni) - Signalure of Regional Director/Designaie Dale 5% ?3 I 5/ yd Supplementary Report for each Subsequent 30 Day'Period (use bottom of form for additional comments Comments - . Signature - Dale Continued/Additional Comments by Superintendent/Designate . A Comments Signature a Date J. n?Sgcuvaq i 7o 34w~w'60 waeH I I Kr - Q5) I Seam/Ill?? . I . - Comments by R?egionai Director/Desi naie - Commenis - Signeiure - 'Daie MM 44:; dbl/LE" WW6 mg- MM 1M2 a?u/ 40M 1/ Distribution: Original - Regional Dileclnr {My forRegional Dirador Review) Copy- lnmaio Fan (:50 075100 (10:04) 5'21?) 000569 . . Ministry?of Community Safety Segregation Decision/Review . 'v -and Correctional Services . .ano - - - ME tnetlt - - - Ottawa?Carleton Dentetlon Ce re Name (Last. First. Middle) Ciienlldenll?callon No. . I 'Reaso or Segregation - . Date of Segregation - ?ve Custody Institution Security El Medical- EI Inmate Request 0793/2014 mutate advtsed of reason for segregatlon - B??tmate advised of opponunity to make oral or Written submissions animate advised of opportunity for interview wilh'Superintendenl 'mate waives opportunity for interview with Superintendent Name of Supe?ntendenUDeeignate (Print) Signature of SuperintendentlDesignete - I Date Francis Noiet. Deputy Superintendent 07/28/2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) inmate Submission 7 SUperinlendent Decision El Release irorn Segregation Continue Segregation Reasons: - Admitted to Seg for: ?fth/LC I '1 Name ofSuperintendenUDeelgnate (Print) I Shanty/5? erintendenUDesignate Date Francis .Nolet, Deputy SUperintendent 07/29/201 4 I I . semegation Review (inmate's segregation to be reviewed EVery 5 days. Interview With inmate to be conducted every 30 days) Inmate Submission - St?aennlendent Decision Release from Segregation Continue Segregation Reasons: - owl Midst? Name of SuperintendentIDesignete (Print) Signature of SupenntendenUDesign'ate . Date $559th Supplementary Report for each Subsequent 30 Day Period (use reverse efform for additionaioomments} ?Commenls SUperinlendenUDesignale Signature '7 Date 7 MMdenN 5.2?1f?rT cso 075-100 (10/04) 000570 Page 2 Regional Director Revlew . - Continued Segregation Supported El Not Sggported 'Comrnents . Name of Regional DirectorlDesignate (Print) I . Signature of Rogional DirectorIDesignato Date 3 20/? cf SUpplementary Report for each Subseguent 30 Day Period .(uso bottom of form for additional comments Comments Signature Date . - ContinUedIAdditional Comments by Superintendent/Dc?gnate' I - Comments - Signature - Date ?~qu 5/ mam--0 (D RM Hi? (Mn - '10 ContinuedIAdditional Comments by Regional DirectorIDeijgnate Commean Signature Date I Aalmpb VmM/?f/Qyw WW 40.7, '4 Hwy/9014 ?j/?a?LngK?frm be [gym/2"? VV J?/k . Dlsirthullon: Original - Regional Director candor Raviuwl Copy - Inmate Flle 8.1 cs0. 075-100 (10104) 5'21 (1) . 000571 m; . .- . A ?F>Ontario - Ottawa~Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Name:_? OTIS quber:_ Inmate written submission for 3.0 day segregatidn revlew: Inmate. Oral Submission for 30 day Segregation Review: ?t 5 NR 521(1) (Tobe completed by Sergeant) . V'Witness Nan-1e: I Inn?te - I . . Witness Signature: 000572 QSegregation Decision/Review - "Ontario OCDCE Hires-roost ~01 Name (Last. First. Middle) enti?cation No. Segregation - Protective Custody Ci Institution Security 8 Medical Inmate Request I Date oi Segregation 22 Aug 2014 Inmate advised of reason for segregation inmate advised of opportunliy for interview with Superintendent inmate advised of opportunity to make orator vilitten submissions Inmate wolves lopportunity for interview with Stiperinlende n1 -Name of Superint denUDesignete (Print) Signature of Supe to Date Low/Kg 22 Aug 2014 - - - - Surgerintendent DeclsIoMThis section must be completed M'ihin 5 d_ey3 or the inmatiggiaoer?enl A smgalr?on) inmate Submission Superintendent Decision CI Release from Segregation Ci Continue Segregation Reason-Name o?uparinlendanUDesignate (Print) Signature oizmanW - Dale (other i 8 93 If inmate Submission Segregation Review (inmate?s segregation to be reviewed ever 5 days. Interview With inmate to be conducted avg! 30 daysi Superintendent Decision Reieese from Segregation B7. Continue Seglggatlon Reuse}; . c) ?9?05. I i I i Signature of SUperintendenUDaslgnate Name of Superintendent/Designate (Print) Date :Pi?etw i 3-74th Suoolementary Report for each Subsewt 30 Day Period (use reverse orrorm Comments" - Sopennlendentlnesignete Signature Date .i I . sAme)? - CSD 075-100 (10104) 5 000573 ?1 Page 2 Regional Director Review Continued Segregation Supponed El Not Supported Comments //7mrr?; 'Mc?a MA I Name of Reglonal DirectorlDeslgnale (Print) Signature of Regional DInectorIDesignale Date cm 5 20/zr/rff: Report for each Subsequent 30 Day Period (use bottom of ?brin for additional comments Qomments . Signature Date. ?7 ContinuedlAdditional Comments Ev Superintendent/Designate Comments Slgnature Date . . L05 NA ?14391obs $218?) 10 . s. . 7f WC) o?cm {fid/ mot alas /a was Jot . dos 1 ContinuedIAdditional'Comments by Regional DireetorlDesignate . Comments Signature Date Mde - deal MM me a. by! 34L b?ad ?eece/320,4 VI 2&2) CSD 075-100 (10/04) ['50 1 - - ?QzersW/L 11 75610! [247}: do6574 safety . Segregation Decrsroanevrew and Correctional-Samaria - - - . an0 - .s?tvOeL-IQ-eiwc-Ji Ottawa-Carleton Dentetlon entre Name (Last, First. Middle) thdentl?catton No. . - Reason(e) for Segregation I Dale of Segregallon 9121/14 I E??rotecuve Custody Institution Secunly El Medics! CI Inmate Request B/tnmate advised of reason for segregation . inmate edvieed of opponunilmw?tten submissions - mate advised of opportunty, [or Interview with Superintendent Inmate waives opporlur?io Interview with uperinlendenl Name of Superintendent/Deelgnale (Print) Sig V?ntendentl?w Dale 0 a5 ,4 [249Superintendent Dec:sron (This section musrbe com tiered iihin 5 days of (he Inmate's placement In segregar on) Inmate Submission I Superintendent Decision Release from Segregation Continue Segregation Reasons: . - - Admitted to Seg for: LK Name of SumeDeg-gnate (Print) Signetu i Superintendew Date rne A/M/f/f/l I Review (Inmate?s segregation to be reviewed every 5 days. iq?rview Min Inmate to be conducted;er 30 dogs) inmate Submission I . Superintendent Decision El Release irom Segregation Continue Reasons: DAY: I in Name of SuperintendenUDeelgnete (Print) . Dale Supplementary Report for gash Subsequent 30 Day Period (use reven? oaer?p foraddirianarcommeni? - Comments Date . Mdeimy s.21(1) CSD 075-100 (10104) 000575 by, L). - . f" Ontario; - Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:_ Number:__ Inmate written submission for 30 day segregation review: 5.21m inmate Oral Submission fer 30 day Segreg'etion Review: (To be completed by sergeant). Inmate Signature: - i . Date: Edd/?f Witness Name . .. Witness? Signature: 000576 Page 2 "Re?nal Director Review" . Continued Segregation Q: Supported Not sugported ?Comments - . I 7""?73 - - - - Name of Regionat Director/Designate (Print) Signature of Regional Directorlbeslgnato Date Supptementary Report for each Subsequent 30 Day Period (use bottom ofform for additional comments Comments Signature Date Continued/Additional Comments by Superintendent/Designate . Comments - - . Signature Date - MMIdd?ml? 25- ltharfbk?nL lo "20- Ly (nee)wa I . 15/: AK . $5 ma?a/REM 14- 10' 55- MLomfc/LAnH . jl- xr?h/ to I inmwuuou u. gage (D ContinuedlAdditional Comments by Regional DirectorIDestgnat Comments I . Signature Date //44 1'54: QL W1, _7 . Ulslt'ibullon'. Rag-0?55} m0! ROM-5W) Copy - Imnato Filo 521(1) 030 075-100 (10104) 00057? ii? Ontario Segregation Decision/Review an ococ Name (Last, First. Middle) Client Identi?cation I Reason(s) for Segregation Protective Custody Institution Security Medical ff inmate Request Dale of Segregallon 21 Oct 2014 Inmate advised of reason for segregelion lnmale advised of opportunliy for interview with Superintendent Inmate advised oiopportunlty to make oral or submissions Inmate waiveegpgonunity for interview with Superintendent Name of Superintendent/Designate (Print) Name of SuperintendenUDeslgnate (Print) Signature of Su ntend nate Date 'Plouffe 21 Oct 2014 Superintendent Decision ?'his section must be completed within 5 days or the Inmate 's (Jinan-Ln! In Inmate Submission - Superintendent Decision Release from Segmation Continue Segregation Reasons: V45 60V 51b 5 Date yum of Superinte eelgnate I 1 er Inmate Submission - Qra??4gxe Se re alien Review (Inmate's segregation to be reviewed ewery 5 dayWW with inmate to be conducted every 30 days) Superintendent Decision El Release from Segregation Continue Segregation Name of Superintendenuoeslgnate (Print) A. .e . (7 SigWGperintendenu net {44% Dale i each SubseqUent 30 Day Period (use 4rerseenonn for additionafco mania) /o?2412w Supplementary Repert fo Comments 'SuperintendanUDeslgnate Signature Dale b.fViT'R CSD 075-100 (10I04) 000578 W3 - . Ontario HG OttaWa-Carietbn Detention Centre SUBMISSION FOR 30 DAY SQGREGATION REVIEWS - inmate Name; OTIS Number:__ Inmate written submission for 30 day segregation review: snzuzud) 5e21nj? :e21(2xn Inmate Oral Submission for 30 day Segregetlon Review: . (To be completed by Sergeant) lnm'ate Signature: -I . Date: I Witness Name: A I Witness Signature: 000570 Page 2 RegLonai Director Review Continued Sggregalion Supgoried Not Supponed Comments - . Name of Regional DirectorlDealgnale (Print) Signature of Regional DIrecloi/Designale Dale ?/quua 0V ao/n/??d Supplementary Repon for each SubseQUent 30 Day Period (use bottom of form for additional comments Comments - 7 Signature Date I Mdelmfy Continued/Additional Comments by Su'perintendenUD?signaie - . Comments. . Signalule Date \iD 05? I . if prim) - - Ill! f'Jf/ micWe) aka: I 4/ i 20' let. Comments by Regional Director/Designate Comments Signature Date . . I 14M #43, 15d - lan m3 ?44,414, 1, . yin MM/bf/K/{Vg/gm {1?40 . Original - Regional Diledor (Gama! Regina! Director Review) 5. NI Copy - lnmaie File cso 0751ooi10'104) 521(1) . . . . 000580 es GE:an and Correctional Services . Ontario. Ministry of Community Safety Segregation Decision/Review Ilulion Ottawa-Carleton Dentetion, deeii?i-QI' Name (Last. First, Middle)- Client identi?cation No. I i. Reasonts) for Segregation Date of Segregation 10120I2014 Inmate advised of reason for segregation mini-nets advised of Opoortuntiy for intenriew with Superintendent [1 Protective Custody minimum Security El Medical Inmate Reoyest ?nmata advised of opportunityt eke oral or written submissions Mnmate waivesopportunlt or Inte iew with Superintendent ITame of SuPerintendentIDesignate (Print) Signet?! SuperintendeWe A?M?/fj/f/ - Date i A [$4,ng a 51/ 2342? I?/el?o/z Inmate Submission Cg,? a . . I Irv Superintendent Decision (This section must be completed within 5 days of ?ejnmaie?s placement In scariegoiion) Sut?rlntendent Decisio?n Continue Segregation Ci Release from Segregation Reasons: Adinitted to Say for: WM Date Surly/bf SuperintendentlDesig ate Home):SuperintendentlDesignate (Print) Signa or If perlntendenllDesi nate - Mm Mata be; 09 d/W 2,2" I I I . I Segregation Revrew (Inmate?s segregation to be review/ed every 5 deg Int swift? inmate to be conducig??y 30 days) Inmate Submission Superintendent Decision Ci Release from Segregation Continue Segregation . o/ Reasons: . DAY: 5 Name _of SuperintendentIDesignate (Print) Date it! ., - Supplementary Repoii for each Subsequent 30 Day Period (use mi/?gerorfannrar additional comet/ls) . Comments SuperintendenUDeslgnale Signature Date . 91(1) 050 075-100 (10?04) 000581 . I Ontario I - {w Ottawa-Carleton Detentic?m Centre SUBMISSION FOR 30 DAY SEIGREGATION REVIEWS inmate Name; ?5 Number:_ lnmate written submission for 30 day segregation review: s.21(1) Inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) inrri'ate Signature: I I Date: Witness Name: Witness Signature: 000582 Regional Director Review Page 2 Vcso 075?100(10104) Continued Segregalion [33/ Supported Not Supported Comments . Neme of Regional DirectorIDasignate (Print) Signature of Regional DireciorlDasigna-te Date ?2 .Mco Km Zo/n/ r50 - Soppiemeniarjy Report for each Subsequent 3t] Day_Period (use bottom of form for additional comments) Qommente Signature Date . I ContinuedlAdditionai Comments by_SuperintendenUDesignate' Comments I Signature Dale L0 ?5 rhc?mfaiwbh jIH/f/?/ 2? ?vat-0?4? 3?7) Lube 165? Continued/Additional Comments bLRegionai DirecitorlDesignate . Comments . . - Signature Date - HZ 4 (oz/46m @3144 I) Marx 3/901? - 1145mm . 7 xix/M 20/ O?ginal-?eglonalDiredor (Or-Liv rReghnai??itodarReWew). I 4 s.NlR Copy-morn s.21(1) '000583 . t? I is: 0ntario Ministry of Community Safety and Correctional Services Segregation Decision/ReView Institution Ottawa-Carleton Dentetion Centre Name (Last. First. Middle) Client Identi?cation No. Reasonis) for Segregetl Date of Segregation 10I19I2014 on . ProtectiVe Custody mutton Securin Medical Inmate Request Inmate advised of opportunil to make oral or written submissions Inmate WeiVes opport n??or lnlervle with Superintendent Inmate advised of reason for segregation Inmate advised otopporluntiy'for Interview with Superintendent Name of SuperintendenUDeeIgnete (Print) Signerntende "Designate - . Date /0 Inmate Superintendent Decision {This section must be completed within 5 days of i inm? 's placement in Superintendent Decision Continue Segregation Reasons: . Admitted to Seg for. Seal.? Release trorn Segregation Name of nate (Print) ?25007th PatBameerDepunLSupedm Date V. Sig? of Superintende ilDesIgnate ,1 9' led army 30 days) elm/2e Segregation Review (inmate?s to be reviewed every 5 days. Iogrvietv?im inmate to be . Inmate Submission - Superintendent Decision Release from Segregation Cl ContinUe Segregation Reasons: Date Name oi Superintendent/Designate (Print) Signature perintendontl eelgnate . Md creme ?ea/44! LO- lib/Li Sugplementary Ffepor?t for each SubseqUent 30' Day Period (use ravage sperm for additional comments) . Comments . Signatore Date MMIddivm . . -. - . -- .. we? - 7 5.21m - Csoms-ioo (10:04) - 000584 Page 2 Regional-Director Review Conlinued Seg?galion CI Supported Not Supported Commenls . . - . Name of RegionalvDireclOrIDoslgnale Signature of Regional DIreclorlDesignale Date Supplementary Report for each Subsequent 30 Day Period (use bottomof form for additional comments) Comments - Signature Date MdeIym Continued/Additional Comments by Superintendent/Designate . . Comments Signature Dale ?0 I - 10 .93- inmnfai?Aoke (noomgwlaiak If ContinuedlAd?ditional Comments by Regional DirectorIDesignale Comments - . .Signalure - . - I . Dale ?AA/mm. 214$; [w V910 3p (7 ,i?qu I . 7 21/1 521,52 - ?444: MLA 7/3414 Val/M A $44.Raphael Dbcdar Review) - male 1 521(1) - - 000585 050 075100 (10104) Eand'IQO'trectibnal73.8Wines ?F>Ontariio I 1-4-0; :Selgregainn .De'cision'lReView Instituuqnj. sHa??ie (L'asnFIra;Midqre) Cli?n; Identi?cagiunm. Rgagongs) for'SegregaIion. vDJri?tlliJllohi'S??Urity. ..U Medical. fD'Ihmate?jRequest" Dale}be Segregalion- -, 981-110(2011f? mhmate'ad?isedl'ofareason A lri?r'i?aat?e adVised S'dpe'rin?t?n'da'nt- -- to, submls?ldns esao'pp ?uidity f?r. ihterVieW'Wi?th? Sup?eriht?nd?ehr- Name .ofLSuperihtendenHoesignal? (Prinn? Date: Su completed Within Ema: inmate's placement?inssagregation) ?lnmate?ubmissi?on S'up?rihtend?e?t ?t?i??ibh: [2.7 ifon: miscoh?dUEt-i i'E??nbi's Ndi?t- Debut? Sab?fim'e?rid?m jg'Signalufg;qf;_ 7 Date 1 081.1 1126314 - -: I . aanaucr?qey?gy?sadays; . 'Sup??riht?ridem?D??i?ia?' :El :2 .. .. . R?asiinsf . Dale- ?Si-Jp?ypi?menf?fyr ?R?bod'forrea?h SubSeq?Uent- Pe?riod for a?di?ilbna?comma?f?) Cgmments- - 1 5.21m 0754:60 (510M) 000586 Page 2 Regional Director Review Continued SegEgation Supported . Not Supported Commenis%opf/afu447l Name of Regional. Director/Designate (Print) Signatureof Regionai DIiectorIDesignate Date 7 Kay-?, Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Continued/Additional Comments by Superintendent/Designate Comments Signature - Date /7 I - Lt) r?xitrcz 85"129 Range)" Ci~?i?1L( Continued/Additional Comments by Regional ?Director/Designate- Comments Signature Date - CAJ knit?M 1! Phi? . ?(hm it? 5% cc: Par-w . 512% (u ?cq 2M ~06! -i 9/ - Distribution: Original - Regional Director Copy - Inmate Fiie snguzxd) saz1u) cso 075100 (Oniy for Regional Direciar Review) 000587 R?g?io?nal :Dir?ctor' Re?iew Pageriz; CGhlihu?d?S?grg'gFatidn' El Not-Supported Comments ?ww?v- ?mme'qr Regional ISignaliJre pat? ?sml?e'me'?tary. Repbd .fbr each ,?s'u'bse'quent bdb?y} P?e??d?(ii??lbbu?ingorfb?n fart-3333:5331 ?dih?'r?m . Comments ?-Signa!ure-? Dal?! . bat?cp' (swam byr-Regignal Director/Designat Comments, "Sig?namna Dalia - 0630720754001001021) - Diat?hutln?n: Original .-, Regional Director {Onlyfo?rR?gianal 69.9? 000588 Bergman?s 5n . Ministry of Community: Safety and Correctional Services .h I pg. Ontario gt?. Segregation Decision/ReView 4L4 ~01 Name (Last, First, Middle) Readonts) for Segregation Protective Custody Institution Security 1 minequest I Mien Ottawa?Carleton Dememre Client Identi?cation No. - i Date of Segregation 2-21-2014 ginmate advised of reason for segregation Inmate advised of ogportuntly for Interview with Superintendent . B?Inmale advised of opportunity to make oral or Written submissions Inmate we v35 opportugtty for interview with Superintendent Name of SuperlntendenUDesIgnate (Print) Francis Nolet, Depuy Superintendent Signature of Whimeelgnate boar/M Dale Superintendent Decision (T his section must be completed within 5 days of the inmate 's placement in segregation} Inmate Subml slon - 1mmSuperintendent Decision El Release from Segregation Mm?? MW Continue Segregation Reasons: Admitted to Segtor: to Ms i We? Name of SuperintendenUDesignale (Print) Signature of ntend UDeslgnele Dale I Francis Nolet, Deputy Superintendent j?e/ I Sgregation Review (inmate 's segregation to be reviewed every 5 days. interview with inmate to 'be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation I Continue Segregation ReasonsName of Silperi ndenUDeslgnate (Print) . Signature 0er Wendie Date ML at? liq . I I Supplementary Report for each Sobsequent 30 Day Period {use reverse arrorm for additional comments) Comments SuperintendenttDesignate Signature 'Date . s.21t1) CSD 075-100 (10104)_ 000589 .0 . .I'Regional Director Review Page 2 Continued Segregation I Supported El N01 Supported Comments ww? mes/we 4; MAM. . Name of Regional Director/Designale (Pn'nl) . I Signature of Regional DIrectorlDesignate Date K, M15 Km I ao/r/fgp Supplementary Report for each Subsequent 30 Div Period (use bottom of form for additional comments Comments Signature Dale Continued/Additional Comments by_Sige?ntendentloesignate Comments 7 0 Signature Dale . . . - - 3Q '?wwfc'rkbk lb~ .Qgg - LII 3' 13/ abo Jme@ 10R a? 30K x3. (.910 (into Continued/Additional Comments by Re?nal Directorloe?nate Commenls Signalure Dale WLMVEZMMIK Ml, yin 3w? 4.40m {Jaw 'r . ?ea .a gull1/7/ a? a Olalnhullon: Original - Regional Director (Only Email Giraud: 7 Copy - lnmaie File 521(1) (:30 075-100 (10104) 000590 . . . Segregation Decision/Review EB Ontario . IIOSJiOnlbei - Miran - ococ\ Name (Last. First. . Ciientldenii?cation No) ?autumn; ml oegregalion Pop Dale of Segregation Protective Custody institution Security Medicai Inmate Request 16 Cm 2014 inmate advised of reason for segregation .E'tnmale advised of opponunily to make oral or written submieelons 7 inmate advised of opportunity for intewiew with Superintendent Inmate waives opportunity for interview with Superintendent Ne?rne oi-Superintendent/Designate (Piint) Signature of - - 'gnete - Dale Plouffe 16 Oct 2014 Superintendent Decision {This section must be completed within 5 days of the Inmatl's piacargenl In segregation) inmate Submission - 99/9 Superintendent Decision El Release from Segregation I Continue Segregation Name ?fSuperlntendentiDeelgnale (Print) 8 Wpenntemw Dale MPReview (Inmate?s segregation to be reviewed every 5 days. In rview w?h inmate to be c?cted every 30 days) Inmate Submission - - - Superintendent Decision El Release from Segregation 2? Continue Segregation Reaeons: v3 Name - ?Slf??r iSupm Date I444 I - /0 Supplementary Report for each Subsequent 30 Day Period (use?veree offomi for additional comments) Comments L/SuperintandenUDeetgnate Signature I Date I I i c. 91(1) . oso 075-100 (10104) 000591 . I I Page2_ n" Regional Director Review . Continued Seggegalion Supponed Not Supported Comments . Name of Regionel DirectorlDesignate Signature of Regional DlrectorIDesignate Dela . Supplementary RepOrt for each Subsequent 30 Day Period (use bottom of form for additional comments) . Comments - Signature Date Continued/Additional Comments 'by Superinten'denUDesignate Comments - Slgnature Dale 1 7 )0 .p?S ?715- 00-1?! Poe) p0] - WV - swag 055 - 35 m?Wm)_ (305 I Fur xv 75/ Continued/Addition?l Comments by Regional Director/Designate - - . Comments 'Slgnature? - x; - Date WW 4141/ I . - . If" 5'7th [161/211 waif? . 7 v/ S. NIH DlBl?hu?on: Ctr-gird - Reg'ronal Director of?cg?nal jl/lr Oopy-lnmaleF'e .. 521(1) CSD 075-100(10104) . 7 ?a - 000592 Ontario. Ministry of Community Safety and Correctional Services Segregation Decision/Review Institution a-Carleton Dentetion Centre Name (Last. First. Middle) giant No. Dale of Segregation 07/19/2014 ncaaurlreij rut Protective Custody El Institution Security Medical El inmate Request minmate adVised of reason for segregation mlnmale advised oiopportunity to make oral or written submissions Inmate advised of opportunity for Interview with Superintendent Enumete waives, opportunity for inienriew with Superintendent Name of Superintendent/Designate (Print) Signature ofSu ITUDesignate Dale Francis Nolet, Deputy Superintendent 07/19/2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregating Inmate Submission Superintendent Decision Release from - Continue Segregation Reasons: . Admitted to Seg forName Of Sup??ntendenUDeslgnete (Print) Signetu rinlendentiDesignate Date Francis Nolet. Deputy Superintendent - i . 07/20/2014 Segregation Review {Inmate's segregation to be reviewed every 5 days. Inten?ew with inmate to be conducted every 30 days) Inmate-Submission ET Superintendent Decision Release from Segregation Continue Segregation c' . Reasons: -V . - Name of SuperintendenUDesignate (Print) Signature of Superinte nate Dale A20 of/ rant-M I Supplementary Report for each Subsequent 30 Day Period (usereverse arrann for additional comments) . . Comments SuperintendenUDesignate Signature Date s.NlR s.21(1) FW ?Wm; . I cso ammo (10/04) 000593 Page 2 . . tie" tonal DirectOr Review I . - Continued Segregation Supported Not Supported ICornments . 347/ Narne of Regional DirectorlDeslgnale (Print) I Signature of Regional DirectorIDestgnale Date Supplementary Repon for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date . - Continued/Additional Comments by Superintendent/Designate Comments Signature Date ?55 .mcgmixlait - I Ml/ zo-ae?Ii110'] Nb" inwwa?x?ov - 2% 1/517 W90 \vx it: it. Continued/Additional Comments by Regional Director/Designate . - Gammants - - Signature I Date V- N74 M44pr Mix/M. 2w [Mi/??f/MA?g/l/vd bag-m?) tap/Um Mirm?ked cur/4" I will 0 enema/(030 075-100 (10104) 000594 a . . Ontario FWAXED - . i/ Segregation Decision/Review Li~c3l _Reaeon(e) for Segregation I Inmate advised of reason for segregation Name (Last. First. Middle) Client ldentl?callon by Prolecthe Custody Institution Security - [3 Medical V?bhs??; Sp-oes - Date of Segregation 16 Oct 2014 Inmate advised of opportunily for Interview with Superintendent l< klnmale Requesl ?16 inmate advised of opportunity to make oral or written submissions inmate waives Opportunity for interview with Superintendent . Name of SuperintendentIDesignate (Print) Plouffe Signature of a te gnate? Date 16 Oct 2014 Superintendent Decision (This section must be completed within 5 do Inmate Submission ys of the inmalJ?s placengent in segregation) Superintendent Decision El Reasons: gm Release from SegLegatlon Continue Segregation Wm} Harriet SuperintendentIDeelgnale (Print) We - Date Sinerlnte 4111/ yv I . Segregation Review (Inmate?s segregation to be reviewed every 5 days. inlet/view w?h inmate to be inmate Submission Superintendent Decision El Release from Segregation Continue Segregation Reasons: . Name of Superintendent/Designate (Print) Siym! fSupW? Date - Lad/a0 4/4 I a rat-IV Supplementary Report for each Subsequent 30 Day Period (uee?var?se arronn comments) Comments . K/SuperlntendenUDesignate Signature Date ls.NlR s.21(1) cso 075-100 (10/04) 000595 Regional Director Review Page 2 Continued Segregation Supported . Nol Supported Comments . . MW 4 Name of Regional DIreclorlDeSignate (Print) Signature of Reglonal DIreciorlDesign-ate Dale Sugplementary Report for each Subsequent 30 Day Period (use bottom of form for additionavl comments) . . Comments Signature Dale ContinuedlAdditional Comments by Superintendent/Designate - Comments. Signature Date Mdelmr )0 read; ?3 [Pots Jaw-""01: 9 If! (30 c3 0 25' 1pc" 96] magma (Do) - 3.5 {Du 5 Comments by Regional Director/Designate - Comments. Signature Date . . - Mam em ,1 35 . 514 I 49-71934 ,1 44/2171 44]? 1 - - A ?jg?fq am. gal/7/A9/4y'la . a - I ug?egt4fafy :31 I '7 A241z49425441/ Zicue . 01";de 'Regl?naIDredorRamV/W Copy-Inmate a cso 075-100 (10104) s.21(1) 000596' - Ministry Sa?e?V Segregation Decision/Review and Correctional Sewices - -- Ontario ME - mm . Fem/5ng - . Ottawa-Carleton Dentetien entre Name (Last, First, Middle) \?ent No. neasoms) segregation - Date of Segregation '3 Protective Custody Institution Security Medical Inmate Request 1 I 10,11,2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy tor Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendentIDesignate (Print) . Signature of Superintendent/Designate Date Superintendent Decision {This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission Superintendent Decision Release from Segregation 7 Ci Continue Seg?gation Reasons: Admitted to Seg for: Mrs? 09 ?359$ Name of SuperintendentlDesignate (Print) - - Signature of SuperintendentlDesignate Date Pat Barnes. A/Deputy SUperintendent Segregation Review (Inmate?s segregation to be reviewed every 5 days. intention: with inmate to be contracted every 30 days) Inmate Submission . Superintendent Decision El Release Irom Segregation Continue Segregation Reasons: . I vyenntend n?UD?e (Print) Date t? a! Elf/kn I I - 1G Supplementary Report for each Subsequent 30 Day Period (use reVerse offarm for addi?e?tcomments) Comments - Superintendent/Designate Signature Dale 050 075-100 (10104) - - 000597 4 n?r' Regional Director Review Page 2 Distrihuilon: Original - Reolonal Director (Only InchgI'onaJ UmdolReviewJ Copy - Inmate Fna 521(1) CSD Continued Segregation . Supported Not Supported comments/Wm?? 5 2 :Av uteri/u: ?mlm Name of Reglonal DirectorIDestgnate (Print) Signature of Regional 0lrectorlDesignate Date Kr Y)an 343/! 1/45 Supplementary Report for each SubseqUent 30 Day Period (use bottom of form for additional comments Comments Signature Date Continued/Additional Comments by Superintendent/Designate - Comments Stgnature Date A Lo migrnn?ug}. 10' or If/ z?zfi?dr??ijr 4/0 ?Sff/L/ -v 39 Mt ConttnUedlAddittonal Commente by Regional Director/Designate . Comments Signature, 1' -. Date - [Am/Wt: (Altai wad/5f.) (Bl/am? 7914'? 12?! 43"75410507620.? 51? .A?n NW QM Magyar." .5: 7w? It?ll/N7A" 415? I M7 4AM?:qu Ur! virility, Tum (NM "7c: - (Nita/yer 7Wan Una/v6 '1 Wane Tum-rm '4 - #77014?? Want we @5ch it - l-tc: cums/i 5'71 yo i Zm? peep! @0440?: Ti him??k M5 49M Camel?1M3" ML 7_ 000598 by, - t: . I arIO 521(1)- 0ttawa~CarIeton Detention Centre INMATE SUBMISSION FOR 30 DAY REVIE f? Inmate Name; OTIS Number:_ Inmate written submission for 30 day segregation review: Inmate OraI Submission for 30 day Segregation Review: (To be completed by Sergeant) I l? L5 I l_ 4%R9Aimw9? 0.143 antimony gig?m C099 MM 41w oo-ivst?Q?. dd I Inmate Signature: Date: All) Lo gig 1 .Witness. Name: 000599 5335'; and correctional Services 10 ~iUt?Oi (m I Ottawa-Carleton Dentelibn Ce Li Client identi?cation Maj . 'Segregation Decision/Review Ontario 'Name (Last. First. Middle) Date 08/142014 - Reason(s) for Segregation roiective Custody CI institution Security Medical B?m?iaie Request . mmate advieed of reason for segregation .. mma advised of opportunity to make oral or written submissions ?male advised ofopponuntly for Interview with Superintendent mi: waives opportunity ior interview with Superintendent Name of SupennlendentIDeelgnete (Pn?ni) SignaWn Mont/Designate Date Francis Nolet, Deputy Superintendent . 08/14/2014 7 . Superintendent Decision (This section must be completed within 5 days of the inmate's placement In segregation} inmate Submission Superintendent Decision CI Release from Segregation Continue Segregation Reasons: . Admitted to?ISeg tor; {Maw/1971466- Mff?kED I To Name of SuperintendentlDeslgnate (Print) Sign me o?SufintjiW Dale Francis Noiet, Deputy Superintendent 08/15/2014 Segreg ation Review (Inmate's eegregation to be reviewed eVery 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregalion [3 Continue Segregation I Reasons: mug wee/irrach- memo PmceiaLawx Name of SupennlendenUDesignate (Print) SiWnde signale Date imwr 7 Kit-7* I - Supplementary Report for each Subsequent 30 031 Period (use reverse ofifon'n foradditianat comments) Comments Superintendent/Designate Signature Dale . - CSD 075-100 (10/04) 521?) Page 2 . Regional Director Review - Continued SegregaliOn EV Sugported Not Supported Comments I a . C9C~nfi 'Nema of Reglonel DIrectorlDestgnale (Print) - Signature of Regional DirectorlDe-stgnate Date A K. M13, ?air/Bx; A 20/? Sun?plementary Rngort for each Subseguent 30 Day Period (use bottom offerm for additional comments Comments Slgnalura Date Continued/Additional Comments by Superintendent/Designate Comments Signature Date - LK- lemme/Lido jo-Lf?tt1 I. I . - 72> to 10- at? ma: wen/4w \ob p. tWLonmgakAoLx on) Lo Mpka Continued/Additional Comments by Regionat Director/Designate I c?mmant5 Signature - Date_ .. . rmf? two (Lenten ?72; (Awe, Rod Mam? I but 1? g?qquo? 41/07 [J1mme valor." AM . Mew <66" 35 a4 m?h. - - /7 PDEQMM . . _t . I . Dlotnhuilon: 0mm - Rag'roml Director (Only [or Regional Director. Cnpy Ina-rule F113 CSD 075-100 (10104) Renew) I 7 I 000601! _Ontario Ministry at Community Safety and Correctional Se Fem; Dist." Segregation Decision/Reyiew \DS-io--M-oi lion - Ottawa-Carleton ?Dentetion Ce re/ Name (Last. First. Middle) Clien iitication N0. - Reason(s) tor Segregation Date of Segregation Protective Custo?y nstitutiun Security Medical Inmate Request 09/10/2014 Q?lnmate advisedot reason for segregation rQ?h?rrn?ate advised of opportunity to make oral or written submissions inmaloadvlsed 0f opponuniiy for interview with Superintendent inmate waivos opportunity for interview with SUperInlendenl Name of Superintendent/Designate (Print) Signature oi Superintendent/Designate Date Sebastien Cote Superintendent Decision (This section must be completed within 5 days of the inmate 's placement in segregation) Inmate Submission . Superintendent Decision Ci Release from Segregation Continue Segregalion Reasons: . Admitted to Seg for: 114Mqu Name of SuperintendenUDesignate (Print) Signature of SuperintendenUDesignate Date Pat. Barnes, AIDeputy Superintendent Segregation ReView (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission 7 Superintendent Decision El Release from Segregation Continue Segregation . Reasons: I DAY: 69 w? i/videi/DIL a SuperintendentiDesignate (Print) Signature ofSuperintendenl/Designate Dale Supplementary Report for?each Subsequent 30 Day Period (use reverse olion'n for additionalcommenis) Comments SuperintendenUDaslgnele Signature Date - - MMIddeyr . cso 075-100 (1or04) s.21(1) 000602 Rgglo?hal Director Review Page 2 .Conlinued Segregalic'm Supported Not Supported Comments . . //7maC? M0 Neme of Reglonel DiredorIDeslgnale (Print) Slgnalure of Regional OlfactorlDesignate' Dale My} 20/(1/4; Report for each Subsequent 30 Day Perlod'juse bottom of form for additional comments Commenle Slgnature Dale ContinuedlAdditional Comments by SUperintendentlDesignate Comments Signature Date I - j' A NIde 35/ . ?10 lnwuxOU?LiAo Bum (Nice-1 9.9 1% - QIC Eh ?jchb?c?r} [o Of Indory?C-A?hlp? 32y] - . i v' I tho-M PoaXNb?u 01/ @40chqu l4- - I J- Lee W-Mx?oakw nu Eeiwqm 9 - I 1 I 1 ?ContinuedlAddItional Comments gv Regi_onai Director/Designate - 7 Comments Slgnaturs_ Date - MT: ?an Nu"? Sdl'7/e/54? 4 wry-4 UN r? 5240 ch HMS db??cot?'?fq?? ?agavch \01 ?(gm ?ve dw?frwu?Tw? - I?m - RMWC ?Zi Q4 . - 7 Dial?nullon: Original - Regional Dlroclnr s. NI s.21(1) CS 0754 00 (1010*?) (MM Copy Inmate Fna i 000603 W5, . . . Ontario Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SEGREGATION REVIEWS Inmate Name; OTIS Number:_ inmate written submission for 30 day segregation review: Inmate Oral Submission fof 30 day Segregation Reg/law; {To be completed by Sergeant) Sew Inmate i Dates Mm ?(al .WitnessName; - Wit_ne_ss Signatgge: . i . 000604 .1 Segregation Decision/Review Ontario - I inns-mew ~63! - a 7 l'ame (Last. First. Middle) \Qilent identi?catio?o: - nyuauntay our - Dale 0f SegregalIOn Protective Custody El institution Security Medical Inmate Request - Gel?11?? d] Inmale advised of reason for segregation inmate advised oi opportunity to make oral or written submissions El inmate advised of opportuniiy for inlenria wilh Superintendenl El inmate waives opportunity ior inierview wilh Superiniendenl Nrme of Superintendent/Designale (Print) - r_ Sign re of nate Dale . ?u . . Chink 10-11?2014 I - I I I Superintendent DeClSIon (This section must be completed wiihin 5 days of m?nmaie?s piecemeal in segregation) in ale Submission I mate placed on suicide watch up admission SLLperintendenl Decision Release from Segregation El Continue Segregalion Reasons: Name of SupennlendenUDesignate (Erint) Signature oi Superintendent/Designate . 1 Dale Segregation Review (inmeie's?gregal ion to be reviewed every 5 Ms. Interview with inmale to be oanducied every 30 ?gs) nmale Submission - - - 5 Superintendent Decision Re ease from Seg?gaiion Coniinue?Segregaiion easons: 6 ?pU Nl oiSupe?nte danUDaslgnate (Print) Sag?lure of Upylendy?slona Date lfAd/i i . ?4714 1M 112;) L, I Supplementary Report for each Subsequent 30 Day Period {use reverse afform for addiliwnis} . Comments SuperintendenUDeslgnaie Signature Date MMIddm fl - - 030 075-100 (10/04) - 000605 Page 2 Re ional Director Review I . 'Con?linued Segregalion Supported Not Supported Cements - Wm Wm; Ww,. Name of Reglonal DiredorIDesignale (Print) - Signature of Regionai DirectorIDesignale Date . ("f/rm (24' S_upplementary Report for eaoh Subsequent 30 Day Period (use bottom of form for additiona! oomments) Comments Signature Date - Continued/Additional Comments by SuperintendentlDesignate Commanls 7 Signature Date - 0o . 13/ I (4L. (LL ?LthgEe'k I I. )0 I .33 Swpbulsfm Aha/mum) $4531ng iffy-9* ContinuedlAdditionaI Comments bLRegional DirectorlDesigmate . Commonls . - - Signature Date 1411.150:ka Am) Don IQ I: ?54? esfc??e? r258 Tab? 5.71315 6M and Wf Lot/V $1191!le A I A - (M ~20 r/Y Dlsl?hunon: D?ginal - Regional'Diredor (Only (arm-930ml madurRm-iaw) Copy- Inmata Fun 050 075100 (10/04) 5.21 (1) 000606 - . ?F>Ontario I - Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Neme:_ I OTIS Inmate w/ritten Submisslan for 30 day segregation review}: I I Inmate Oral Submission for 30 day Segregation Review: I (Te be completed by Sergeant) hu?q. Inmate Signatune?: 7 Date: (QM (9 WitnesS Name: Witness Signature: - 000607 Ministry or Community Safety and Correctional Services Segregation Decision/Review Ontario Institution 'iO Etude] I Name (Last, First. Middle) ?0 awe-Carleton Dame ((iient identi?cation No. . 14?! yum tor Segregation r, . I Protective Custody . institution Security Medical [3 mmale Request Date of Segregation 12?14?201 3 [Zinmate advised ofreason for segregation Inmate advised of opportunity for interview with Superintendent Btnmale advised of opportunity to make-oral or written submissions Inmate waives opportunity for interview With Superintendent Name of Supenntendenuoesignele (Print) Francis Nolet. Deputy Superintendent Dale Superintendent Decision section-must be completed within 5 days or the inmate's placement in segregation) Signature Want/Designate "if inmate Submission I Release from Segregation Superintendent Decision Continue Segregation Reasons: . . Admitted to Seg for: suicide watch - . Name of Superintendent/Designate (Print) Francis Nolet, Deputy SUperintendent Signature oi SupeWe - Date A . 7 Review (inmate's segregation in be reviewed every 5 days. interview with inmate to be conducted every 30 de Inmate Submission . Superintendent Decision Continue Segregation Reasons: - DAY: 5 - ?More Signature-EtiSineri Do Dale - - rim/,3 I . - I . SupplementaryReport for each Subsequent 30 Day Period {use reverse arrorm for additionai comments) I Comments- SuperinteridentlDesiQnate Signature - Date 650 075?100 (10104) 521(1) 000608 Regional Director Review Page 2 Continued Segregation Supporled NoiSuonned Comments - . . I Name,of Regional DlteclorlDesignalo (Print) I Signature of Regional Director/Designate Dale 653..w SupplementaDLReport for each Subsequent 30 Day Period (use bottom of form for. additional eomments Comments Slgnature Dale . Mdelyny. Comments by SugerintendenUDesignate Comments . 'lure Dale .1 - 306 emf; ?S?l?f?l . .3 - . tuft"? . Q0 3% rags?ma. lu?M waft? 7 A a} I 336) reacLS-beg L) 29g MAIL .3 C330 5 ContinuedlAdditional Comments by'R?egiooal Director/Designate - Commenle I Signature Date I . \pbg'rt own. ?s alt/ES?? '5 rich/31W Mo. [rhea-J - 60? ii 6 id W00 mar-w s.21(1) cso 070100(10104) Distanunon: Original - RegimaI Dimqu (Onry (orRogiona! D'rcdorRevhw) Copy - Irinale File '000609 Pp Izrs'bntario 'Ottawa-Ca rl'eton Detention Centre . INMATE SUBMISSION FOR so DAY REVIEWS Inmate -Name:_ OTIS Number:_ Inmate Written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) tuK ,Inm'ate Signature 7 I DateijUOJ ?114 I) Heel ~e.w_ltness Signature: - . .521?) 000610 it . Ministry of Community Safety . - evi - and Correctional Services 3 gr .gatlon Dee'smn/R; ew arto ME E) instilutio Ottawa-Carleton Dentetion Ce ire) I Name (Last. First. Middle) \Jilent identi?cation N2 some) for Segregation . I Date of Segregation gProtective Custody Institution Security Medical El Inmate Request - 07/19/2014 advised oi reason for segregation gnaw advised of opportunity to make oral or written Submissions . I . at. Inmate advised of?opponuniiy for Interview with Superintenden nmate Waives opportunity for interview with Superintendent Name of SuperintendentiDesignate (Print) - Signature oi WUDesignate Date Francis Noiet. Deputy Superintendent - A 07/19/2014 I SUperintendent Decision (This section must be completed within 5 days of the inmate 's placement in segregation) Inmate Submission - . . SUperintendent Decision Ci Release from Semaiion ET Continue Segregation Reasons: 7 A Admitted to 899 for:. I ?n 7 Name of Superintendent/Designate (Print) - Signature oWy?Designate Date - Francis Noiet. Deputy Superintendent 07/20/2014 Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission Su erinlendent Decision Reiease from Se re aiion Continue Segregation ReasonsName of Superi 'lendenUWPt-int) - - Signature oWM?i/Designate Date - - 0 - - - 7 ?Dbl-ii SupplementaryReport for each Subsequent 30 Day Period (use reverse arrorm for addi?onaicomn'ients) Comments . - Superintendent/Designate Signature Date - .s.NiR a . CSD 075-100 (10104) 7 821(1) I 000611 ?l I Page2 I Rggional Director Review - Conlinued Segrggitlnn Supported Not SUpported WW qu-i i gnu/4 am. we? Nnme of Regional DlredorlDaslgnale (Pnnl) Signature of Regional DiraplorIDeslgnate Dale ~Wo ,4 6M. Zo/{g/q? Supplementary Report for each Subsequent 30 Day Period [use bottom or form for additional comments Comments Slgnaluro Date Continued/Additional Comments by Superintendent/Designate Comments Signalure Dale . . . . - - . a: NH loo \th?i QME ?0 -37* ?Vin: . db obj? 6 1m Wk Continued/Additlonal Comments gyj-Lelpionai Director/Designate . Comments Signature Date MMIdd/yy? IJQX 51%? 'Ul" ?(Ex/1t? we) mm A 15mm (Jr mar-? fir {cc/566.0% (Ir/(179% Dlsu'lnunon: Original - Regional Dlmolor Warming Oopy-hmie?le . s.NlR 07010000104) . s.21(1) . . . . 000612 7 I 3W>Ontario Ottawa?Ca rieton Detention Centre SUBMISSION FOR 30 DAY REVIEWS Inmate Name; Ions Number:__ Inmate written submission for 30 day segregation review: Inmate" Oral Submission for30 day Segregation Review: (To be completed by Sergeant) I inm'ate Signature: - - Data?w??df Witness Mamie: ?ea-o 7? - W-r' - - Witness Signature: I 000613 Hal $1 A. 33. I ?mat?- Safety . Segregation Decisioaneview - and Correctronal Servrcos I . - narlo - toggrmeruwoi a FAKE "a 1/ Ottawa?Carleton Dentetion Ce Name (Last. First. ixq is WW - Re n(5) tor Segregation - Date of Segregation ?oteotim custody Institution Security ?/Medroar inmate Reauasl 03/211201 4 .Z?lnmate advised of opportunity to make oral or written submissions Liza/yanate advised of reason for segregation inmate advised of opportunity for interview with Superintendent mmate fives opportunity for interview with Superlntendent [?1me ofSuperintendenItDeslgnate (Print) Signature rint dentlDesignate Date . . 03/21/2014 We Noiet. Deputy Superintendent . I endent Decision (This section must be oompteted within 5 days the inmate?s placement in s?ogp?tlon) .atu Submission . Superintendent DecisIOn Retease from S_egregatton Continue Segregation - Reasons: . . Admitted to Seg for. gt; add . Name ofsuparintandentlDesignete (Print) Signature cVall?waasignele Date Francis Nolet. Deputy Superintendent I . 03/22/2014 II Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission . . . Superintendent Decision CI Release from Segregation rCantinue Segregation Wag _W?v Name of erintandenUDeslgnate . Signature of rintendentlDeslgnate Date Mot/C - 0341 .4 r, I I - Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments)_ - Comments Superintendent/Deslgnate Signature Date I 050 075-100 (10104) s.21(1) 000614 Page 2? ll -- Review - . . Contlnuad Se re atton Supported . - Not Supported (tommenla 9W W044 Name of District Administrator/Designate (Print) I Signature 0i Date gym?: I 7W'zy Supplementary Report for each Subsequent 30 Day Period (use bottom of. fonn for additional comments Comments - Signature Date . MM/daiym ContinuodlA'ddltIOhai Comments by Superintendent/De'sigtate Comments . . Signature 200' at,? ?mM? . . . 704?"? {mun bit; I [O'B?l?f .9510 - . nor (mun woaf - H, 930 Outs m5? 8 Continued/Additional Comments by District Administrator/Desi nate Comments . I Signature Date - . - Wit/i?m( and 1.541va baa/44b glam Lu Mr 4424., 1/ - I, I L71. 4.1?/t?/7Ao/I - - Distribution: Original - Distria Administrator (On Ad?ziniarafor?arhwj Copy-inmate i 000 075-100 (1 0104) 5.21 (1 000615 Ontario Ministry of Community Safety and Correctional Services Segregat'on DecISIoanevrew ?awa-Carleton Dentem ClieW Name (Last. First. Middle) n- for Segregation - . Dale of Segregation mrolective Custody Imitu?on Security El Medical El Inmate Request 08/07/2014 IZ'inrnate advised of reason for segregation Emma advised of opportunity to make oral or written submissions Inmate advised of opportunliy for interview with Superintendent Inmalempponunity tor interview with Superintendent Name of SuperintendentrDeeignate (Print) Dale - 08/ 07/201 4 Francis Noiet. Deputy Superintendent Superintendent Decision (This section must be completed within 5 dais or the Inmate 's placement in segregation) Inmate Submission 7 494 Superintendent Decision El Release from Segregation Continue Segregation Reasons: Admitted to see for: Mind?pr Name of SuperintendentrDesignale (Print) 4 . Signal ofSu ant/Designate - Dale I i "0810812014 Francis Nolet, Deputy Superintendent 7 I Segregation Review (Inmate 's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) lnrriate Submission - 9/ Superintendent Decision 13 Release from Segregation 9/ Continue Segregation Reasons: DAY: Mien/0061 Name o'tS en Signature 0 intendenUDesignate Dale {5 Supplementary Report for each Subsequent 30 Day Period {use reverse or form for additional comments) Commente' SuperintendenUDesignate Signature Date - S.NIR cso 075-100 (10104) 521(1) 000616 A Page 2 - ?Re??ai Director Review Continued Segregation SuPpor?led [3 Not Supported comments ?99;qu WM u/j/ow?af 9?4! mw- ?ea/w JK sJu'C?v?a Name. of Regional DirectorlDesignale (Print) Signature of Regional Director/Deelgnate Date K. Wis. - 7 Am/ (cf ?ppiementalReport for each Subsequent 30 Day Period (use bottom of form for additional comments I Comments 0 Signature Date . ContinuedIAddition-ai Comments by SuperintendenilDesignate Comments - . Signature Dale 0 . ?to 7f Lemur??xx icy a: 35 JD. 8S Semth '{ojlv/Ii/ I ?10 ?1 WV vii?1? #45 Ft ContinuedIAdditionai Comments-by Regional Director/Designate Comments . Signature Date Wm ?p?mma?t: 2544/? . f_ {frag/4&1 340 My may. moi 4.6 I bg- 3L (9ch ?m was v?v- - I Distribution: Original - Regional Director (Onufor?eglonal Director Ra . . Copy - inmate File . CSD 075-100 (10/04) . I g/Zdr/ s.21(1) 000617 $50 Segregation Decision/Review arto - 4041,50, Cientldeniil?rcalionNo: Name (Lest, Middle) Reason(s) tor Segregation a . u/ - Date of Segregation mrotective Custody institution Security '3 Medical Inmate Request I 09/08/2914 Z?Inmate advised of reason [or segregation . B?ate advised of opportunity to make oral or written submissions . Inmate advised of opportunity for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of parinlendenUDesignaie(Print) Signature erinlendenUDasignate I Date ?P/gii?nx/ . - Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission I 9/ Superintendent Decision Release from Segregation i3, ?Continue Segregation ReasonsCD Admitted to Seg for: i (Mpg-'7 (?be A Name of SuperintendenUDesignate (Print) - Signature Subuun' tandem/Designate Date - ?re-rv Pat Barnes. AIDeputy Superintendent Seg?gation Review {Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted even/.30 days) inmate Submission Superintendent Decision Release from Segregation - Continue Segregation I Name ofSuporiniondenUDeslgnale (Prinl) I Signaturywe?signale Dale ?Lgb?m? 6i VJ Sapplementary Report for each Subsequent 30 Day Period (use reverse afform foradditionat comments) Comments SuperintendentlDesignate Signature Date - 7? [Le-Mm} 1 Qt Ar ?ts/L sq I CSD 075-100 (10104) s.NlR' s.21(1) - 000618 . . Pagez igional Director Review I antinued Segregatibn Supp?oned El Not Supported . ?mm ?hafm Nnma of Regional Diredormesignaie (Print) - Signature of Regional DirectorlDesignate Date Dev-H's 0 MW S'uppiemeniaty Report fof each SubseqUeni 30 Day Period (use bottom of form'for additional commanis Comments . Signature 'Daie Continued/Additional Comments by Superintendent/Designate Commenis . Signature . Dale . I (A MMIde'myr 5? rm? i! L: [0?13'1 .40 4k chkEul/ g1 09? /y 00 192/ ?abtog?' gc/ ContinuedlAdditional Comments by Regionai Director/Designate . . . Comments Signainrq - Dale Mm l' 7% 4 Al?iigmq 2 400,3 eyr'?i/ 5&21u) :a21(2xn 08 075-1 00 [10!04) 000619 - DBOntario Ottawa~Carleton Detention Centre . INMATE FOR 30 DAY news 5 Inmate Name:_ OTIS Number:_ inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: (Tobe completed by Sergeant) Vlnm?ate Signature: Date: 2410/ Witness Name: Alix/0 WitnessSignature: s.21(1) - 000620 Ministry of Community Safety and Correctional Services 0.: Ontario Segregation Decision/ReView Ottawa-Carleton Dentetion Qe I re nos?low 0! Nem?a (Lasl. First. Middle) Reaeonts) for Segregatio - Protective Custody .. Won Security Medical El inmate Request . tidenlifleation Dale of Segregation 1 0108/2014 inmate advised ol?reason for segregation inmate advised of opportunliy for Interview with Superintendent Inmate advised of opportunity to make oral or written submissions lnmatewaives opportunin for interview with Superintendent Pat Barnes. NDeputy Superintendent Name of SuperintendenUDeslgnate (Print) Signature uparlnlendenUDesignate Date 'Q?fhm . Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission Superintendent Decision Release from Semalion EL. Continue Segregation Reasons: i Admitted to Seg for: 5? (pull/FT Name of SuperintendentlDesignale (Print) Date Signature upetiniendentloesignate Segr_egation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission Superintendent Decision Release from Segregation Reasonsi DAY: 5 team-IR ?rConiinue Segregation Name of Superintendent/Designate (Print) Signature Wnate Date QP?Q?we?t.? I (a v- a. Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments . SuperinlendenUDeelgnale Signature Date - S.NIR s.21(1) - 075-100 (1 0104) 000621 Regional Director Review Page 2 Continuad Segregalion Supported Comments Signature of Regionel DirectorIDeslgnale Name of Reglona! Dlreo?torlDesignate (Print) Date fe?o ems; ?oh 1 7 I70 Supplementary Report for each Subsequent 30 Day Period (Use bottom of form for additional comments Comments Slgnalure Date ContinuedIAdditional Comments by SuperintendentIDesignate Commenls . - Slgnalure Date I 15/ Saturn/M . lo ?We e- ?wv? Aw? 1? Continued/Additional Comments by Regional Director/Designate . Comments Slgnalure Dale - muggy/M [If [1/1 dag/11.4.4.4. Av ma, z/97/2045/ a %0u-5//520/f/, //71 sJuna (:80 075400 (10/04) 5-21 (1) Copy - Inmal angina! - RegionaI?DTrmor 0 - 000622 . - DROntario Ottawa-Cirieton Detention Centre JNMATE FOR so DAY REVIEWS Inmate Name; OTIS Number:_ Inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: .1 (To be cornpleted by'Sergeant) lnm'ate Signature: - Date: No l/ Witness Name: S.NIR 521(1) Witness Slgnature: 000623 r. M'mstw 0f 9?mmunlt? Safety Segregation Decision/Review . - a and Correctional Sen/Ices - . . arlo - 7 . - . .oclLt-Ol - have Ottawa?Carleton Dentetion Centr Reason(s) for Segregation Date of Segregation Protective Custody 1] Securitv .EMedical [inmate Request 10? 0312014 Inmate advised of reason for segregation inmate advised oi opportunity to make oral or written submissions inmate advised of opportunity [or interview With Superintendent El Inmate waives opportunity Wm}: Superintendent Name of Superintendent/Designate (Print) Signal re 0 Superintendentmigy Date Superintendent Decision {This section must be completed Within 5 days of initiates placement in Inmate Submission 1e Superintendent Decision Release from Semation 2' Continue Segregation Reasons: - Admitted to Seg for: Med Obs tine ofzrperlnlandentlDasIgnate (Print) ,7 Signatur Superintende tlDesig ate Date I {bro - . . Pet?Barn . Want baa 005 x? /9 9/30} I I . . Review {Inmate?s segregation to be reviewed every 5 days. Interview inmate to be conducted every 30 days) inmate Submission 7 . Superintendent Decision Release from Segregation Continue Reasons: DAY: g2 NJ my, . Name of Sup?rintendanUDeslgnate (Print) Signyuporlntendw I Date . At 10* [3?7V'l Supplementary Report for each Subsequent 30 Day Period (use for additionafo/omments) Comments ?SuperintendenUDeslgnate Signature Date S.NIR ?5721 (1) CSD 075-100 (10104) 000624 Page 2 Regional Director Review Continued Seggagation Supported 7 NoiSupporied' ommenls c. I W41 our-LA Wr?f. . Name of Regional DirectorIDesignale (Print) - Signature of Regional DirectorIDeslgnale Date . ,4 Juana Km fer?e 7 Supplementary Report for each SubseqUent 30 Day Period (use bottom of form for additional comments Comments Signature Date - Continued/Additional Comments by Superintendent/Designate Comments, . . VSIQnature. - Date . Miami [D'iof'l?f 14' no.? 5 I I, m. QI?l?ifl obs?749w)?. 14f ?y w?7-M Continued/Additional Comments by Regional Director/Designate Comments - Signature Date 0 . - wat?sm?ggt gm? [lg-Mg}: . :3 WA o/o? CL mince/?u ail?r" "Jar/#19154?4Lor/ '5?f/e16/f/g 1 x. - 7/20/3/ Disldbuilon: Original - Regional Director {Only torRegionoJ Decatur Review) Copy-InmateFIle cso 075-100 (1 0104) 521(1) 000625 . by, . 15F0ntano; Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS inmate Name:_ I Number:_' inmate written submissi0n for 30 day segregation review: inm?ate Oral Submission for 30 day Segregation Review: . . (To be completed by Sergeant) inm'ate Signature} Date: Ir Witness Name: A M47) - s.21(1) Witness Signature: 000626 .07 - Ontario Segregation Decision/Review Li -. 0t eases: institution Name (Last. First. Middle) rReasoMs) tor Segregation 3 A - Date oi Segregation CI Protective Custody institution Security. Medical El inmate Request Oct 7'20? inmate advised of reason for segregation Inmate advised oi opportunity to make oral or Written submissions inmate advised of opportuniiyrfor interview wilh Sg?erintendent Inmate waives opportunity for Interview with Superintendent 7 Name of SubenntendenUD?signate (Print) Signatu Superintenden esignate Date R.NIXON . i '9 . 1010712014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission . - Superintendent Decision Release from Semaiion El Continue Segregation Reasons: :3 \o?p wa a wk? Name of SuperintehdenUDesignate (Print) 7 Signature ofSuperintendenUDesignate Dale Segregation Review [inmate's segregation to be reviewed every 5 days. tntewiew with inmate to be condor:th every 39 days) inmate Submission Superintendent Decision 13 Release from Segregation Continue SegregatiOn Reasons: teuperinydenuo nate (Print) Date . . . m/ I I Suopiementary Report for each Subsequent 30 Div Period (use reverse offonn for adSitronaI comments) I I Comments SuperintendenUDesignale Signature Date CSD 075-100 - I 000627 Page 2 @ional Director Review 4 - 1 _.Conlinued Supported 13? Not Suppon?d Comments . I I M1164 ?ag/:4 cam-L Name of Regional DIreclor/Designale (Print) Signature of Raglona'l DireclorlDeslgnale Dale Supplementary Report for each Subsguent 30 Day Period (use bottom of form for additional comments Comm?nls Signa?hire Dale CbntinuedlAdditional Commenfs by SgperintendentlD'esignate - Signalure Dale Comments . . IQ jor {7'14 9w ?7 .04 ?ckle? 90/ 1(5, v/L/ I HA PM @%g(xo (930', :1 94,? Pz?gkvb? Continued/Additional Comments by Regional Director/Designate Emmenls - . Signature Date . 4440/65 H74 Ma! vi Mir/m2 4, 1 my, #7 a DI=Mbullom Origins! - Regional 01mm {if for Regional ?30:ch aniow inmata Ila - CSD 075-100 (10I04) 000628 I Ontario - OttaWa-Carieton Detention INMATE SUBMISSION FOR 30 DAY SEGREGATION REVIEWS inmate Name:_ OTIS Number:_ Inmate written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: (To be completed by?Sergeant) i?nm?ateSignature: I I Date: Witness Name; - Witness Signature: s.21(1) 000629 -- ?i Segregation Decision/Review ?a EROntario ?iO?iU~Dt 0000 Name (Last, First. Middle) - Ciienildenliticailon?ity Reasonis) tor Segregation - Date of Segregation i:i Protective Custody El Institution Security Medical Inmate Request 5 sep 2014 Ci inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions nlendent I Date 5 Sep 2014 Ci inmate advised or opportunliy for interview with Superintendent Name of SuperlnlendenilDesignaie (Print) 0MPOWH w, Superintendent Decision (This section must be oompteted within 5 days of the Inmate's placement in segregation) Inmate Submission 42/ Superintendent Decision Release from Seg?gailon Continue Segregation Reasons: . - Name of SuperintendeniIDesignele (Print) Signature oi SuperintendenilDeslgnate Date Now i I 0i"! o-M I Segregation Review (Inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission Superintendent Decision El Release from Segregation Cir- Continue Segregation Reasons: bu, . Name of SuperintendenltDestgnale (Print) - . Signatht/Designete Date ENE - - r) l?f Supplementary Repon for each Subsequent 30 Day Period (use reverse arrorm for additional comments) Comments SuperintendentIDeeignale Signature Date (10104) 521(1) I 000630 . - . Page 2 Regionai Director Review - Continued Segregation Supported - Not Supported Comments . 7 Win/I?wm??a??anv?o?lw ?Wt? Name of Regional DirectoriDesignate (Print) Signature of Regionat DirectorIDeeignate Date Supplementary Report for each Subsequent 30 DaLPeriod (use bottom of form for additional comments) I Comments Signature Data Continued/Additional Comments by SuperintendeniIDesignate comments .. Signature Date .o 35?: 43w 4 to?jto \k 11?10 Wm 7/4 or lf?fLeo 0.29? rawzk . ContinuedIAddittonai Comments by Remnal DirectorIDesignate Comments - -, Signature Date - - - - . I ?mj( Md 4%va La - Mam, a. . . ?3'72 an M44. Mm MAM ?ip/#4 44 44W s_ Dlatthuuon: Orig'ml - Regional Dirodor {Only for Regional Dimer Review) . 09w - inmate File - 5.21 (1 CSD 075-100 (10l04) 000631 Ministry of Community Safety and Correctional Services Ontario . Name (Last. First. Middle) boot; FAKE Segregation Decision/Review i ininIuIi Itawa-Carleton Dentetion Cent dentiticalion No. Heason(s) [or Segregation . El Protective Custody Security [3 Medical inmate Request Date or Segregation 1-8-2014 ?r?ate advised of reason for segregation Inmate advised of opportunity for interview with Superintendent gynale advised of opportunity to make oral or 'w?iten submissions Inmate Waivers opportunity fer Interview with Superintendent Name of Superintendent/Designate (Print) Francis Noiet, Deputy Superintendent Signature of SUpeWnU/Desienaie Superintendent Decision (This section must be completed within 5 days of the inmate-'5 placement in segregation) "3312/ Inmate Submission no El Superintendent Decision Continue Segregation Release from Segregation Reasons: Admitted to Seg for: Incompatible Name of SuperintendenUDesignate (Print) Francis Nolet, Deputy Soperintendent Signature of SuWMignaie Dale . I ha Rewew (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) [Oi Inmate Submission Superintendent Decision Release from Seg?galion Continue Segregation Reasons: I DAY: #5 . t?n? Cam/00: (2 vote. eofSuperintendenUDesignate (Print) Signature olS nden esignale 'Dale imam Noose! Jam 1 Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additioneloomments) . Commenis SuperintendenUDesignate Signature Date - . . 2 _r CSD 075-100 (10104) 521(1) 000632 Page 2 - Regional Director Review Continued Segregation Supported D- Not Supponed Cements, pa: 1g, W. '20 7 W??cs I I Name of Regional DlreclorIDesignate (Prinl) Signature of Regional Directorlbeelgnale Dale - K- 7)th KW Subplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Commenls I Signature Dale . . ContinuediAdditional Comments by SuperintendenUDesignate I "-Cpmmente Slgnalure Dale A - 97.#15; . . 0. 9135 \meanL I 4 . \Wmeemu - WW ,4 9:15 . maze-N 300 \hmmwabQ' I I q. [of Con?nuedlAddition?l Comments by Regional Director/Designate Commenls - 1' ?Signature Dale Elm HM- I ??g/4L1 Van M- mad {4sz 5 - WI y} 44121440] ?ew/V II 7m %4/2/5{441 Ba Dlauibullon: any?'anal - Regina! Diroda' (OnylorReghnaI War Review} NIR Copy.- lnmalu Filo s.21(1) cso hrs-100 (10104) 000633 .Py- - . DROntario Ottawa-Carieton Detention Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION R'sviews .In'mate Name:_J OTIS Number:_ Inmate written submission for 30 day segregation review: Inmate Oral Submission for_ 30 day Segregation Review: (To be completed by Sergeant) Inmate Signature: . Date: 20 - Witness Name: WitnessSig'nature: 000634 . is KPOntarlo Hm . E53139 Segregation Decision/ReView tog-ab OCDC Name (Last. First. Middle) Client Idemin i Reason(s) tor Segregation Protective Custody Security Medical lnmaleRequesl (M 0,1117? Dale of Segregalion 5 Sept 2014 Lulu. Nor" ?ux/c770? wan ihmaie advised of reason for segregation Inmate advised oi opponuntimr interview with Superintendent Inmate advised of opportunity to make oral or written submissions Inmate waives (3meth with Superintendent Name of SuperlntendenUDeslgnale (Print) Bylaw enu Dale . 3 Plouffe 5 Sept 2014 Superintendent Decision This section must be completed Within 5 days of the inm?e's placement in segreggllon) I inmate Submission Superintendentnecision Release lrom Segregation VConiinue seggzgation Reasons: .w i 00 in Name of SuperintendenilDeeignate (Print) Date Signature oi Superin denUDeslgnate inmate Submission I Segregation Review (inmate's segmgalion to be reviewed event 5 days. interview with inmate to be conducted strer 30 days)- I Superintendent Decision Ci Release from Segregation Continue Segregglion - Reasons: Name or SuperintendenUDesignate (Print) Signature of SuperintendentiDesignaie Date 1 . Supplementary Report for each Subsequent 30 Day Period (use reverse offomi ror - Comments . SuperintendenliDesignaie Signature Date 7 cso 075?100 (10104) s.21(1) 000635 Re?onal Director Review Page 2 Continued .Segregllon [Er Supported No! Sugg?ed Comments ?ow/1 Apal- 47 I. Name of Regional birectorlDeelgnate (Print) Signature of Regional DirectoriDeaiQnale Dale (1 Bar?m Kim'XF?a- 7 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Continued/Additional Comments by SuperintendenUDesignate Comments . Slgnalure Dale A into [17- km f/r [Cf . 1040.. (1 Sb jo,ggfric1 thovviPO-Anbakt (90 Continued/Additional Comments by Reglonal Director/Designate . Comments Slgnature Dale M7: Milk/j/JWL 'lL l) Mpg/493? 7 . (2121-4/ s.NiR .- s.21(1) 075-100 (10104) nl?dbu?on: 0119M Regional Director Wot Regional D'redorReviaw) Cepy - Inmale File dig/mz 000636 A PM I f? ?70" 020ntario - I 0ttawg;Carleton Det?ntion Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS inmate Name:__ 4 OTIS Number:__ Inmate-written submission for 30 day segregation review: lnmat? Orai Submission for 30 day Segregation Review: (To be completed by Sergeant) Inmate Signat?re: (0,36% SW Date:?oJi{ 2gb! Witness Name: ?1 I s.l\ilR - 521(1) 'Wltness Signature: . 000637 . Segregation Decision/Review 3: Ontario Gog; Ml Lt Cat d?Etilution Ottawa - Carleton Detention Centre I Name (Last. First. Middle) Walton No. naasonts) ougrugeuon Dale of Segregation Protective Custody Institution Security Medical Inmate Request 0510712014 . Inmate advised oi reason for segregation Inmate advised of opponunlty to make oral or written submissions . Inmate advised of opportunity for interview with S?erintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) SignaWerintendenuoesignate Date Mr. Frank Notet - x. /t//V7 05/07/2014 Superintendent Decision (This sedlon must be completed within 5 days of the inmate's piecemeal in segregation) Inmate Submission Superintendent Decision CI Release from Segregation Continue Segregation ReasonsSUperInlendentIDesignate (Print) Signature oWgnme Dale be nor . Segregation Review {Inmate?s segregation in be reviewed every 5 days. interview with Inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation 8' Continue Segregation Reasons: Name 0?:nntendentloesignate (Print) 'Slgnatme oi Weignem Dale . - I Suppiementary Report for each Subsequent 30 Day Period {use reverse offarm for additional comments} Comments SuperintendentlDesignate SignatUre Dale are"? 030 075-100 (1004) 521(1) I - 000638 Ontario Ottawa-Carleton Detention Centre I INMATE SUBMISSION FOR so DAVSQREGATION REVIEWS OTIS Number:__? Inmate Name:_ Inmate written submission for 30 day segregation review: Inmate Oral?ubmis?ton for 30 day Segregation Review: I (To be completed by Sergeant) Date: Inmate Signature: Witness?NarIIe: . Witness Signaturez' 521(1) 000639 Page 2 ,0 Not Supported Regional Directo'r Review - Coniinued Siqregaiion Supported fume" 7 Anne/w 0W red/u i4 Dale Name of Reglonal Diredorloesignala (Print) Signature of Regional DirectorlDesigneie K~Muis 7463A mm?: a. Regen for each Subeequent 30 Day Period M39 bottom of form for additional comments Comments Signature Dale 7 ContinuedlAdditional Comments by SuperintendentlDesiggate . Comments . 'gnalure Date . - i (r MNMk?ngyr . SS knika U.an HULK ItNeg Lin) \wwx vw?r 10- 9V ITO A rig? (?419433 1mm er ?va LKD - . ContinuedIAdditional Comments by Regional DirectorlDeiianate Comments Signaiure Date - lamb!" 9715/ DIal?bullnn: Otiginsl - Reulonai Diredor (only for Repbna! [Lieder Rewbw) Copy - lnmala File S.NIR 075-100(10104) 5 21(1) 000640 Ontario Ministry of Community Safety and Correctional Services Segregation DecisionIReview mo lLi - LS) I Name (Last, First, Middle) ?9ch Ottawa-Carleton Dentetion Ce tre ?l nl Identi?cation No. I Reason(s) tor Segregation Protective Custody El Institution Security Medical [j inmate Request Data of Segregation 10/06/2014 Mmate advised of reason for segregation Wale advised of opportunity for interview with Superintendent Inmate advised of opportunity to make oral or written submissions Inmate waives with Superintendent . New? SuperintendentiDesignate (Print) ?rm/,9 541W 19,6 Signytu?superlntendentl signate Sate [43/444] inmate Submission 92/ "w Superintendent Decision (This section must be oor?pleted within 5 days cane inmate's placement In segregation} - Superintendent Decision Release from segregation Reasons: ?Admittedto Segfor: @077 sz [27 Continue Nam'e?t (Print) 4?4? 0 date Pat?'BeraeerNeru moan: inmate Submission Segregation Review (Inmate?s segregation to be reviewed every 5 days. Integ?emwil?h inmate to be conductgevery 30 days) Signnyuperlntendemw Date 1 0/ 7 I Superintendent Decision Release from Segregation Continue Segregation Reasons: DAY: )i/Mf ale (Print) erlnte en Superi eslgnate Date .Ll 01.? I 'ux/t 10' ii? Supplementary Report for each Subsequent 30 Day Period (use reverse afform fared "on comments) Comments . SuperintendenUDeslgnate Slgnetum Date MMIddIym .. -4 '050 075?100 (10104) s.NlR s.21(1) 000641 Page 2 Regional Director Review Conlinued Segregation Supported Not Supported Comments . . Slynalme of Regional DirectorlDeslgnaie Date Name of Regional DirectorlDesignale DIM: ?CrRV?ea 7 '7 ,5 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for edditional comments Comments Slgnature Dale Continued/Additional Comments by Superintendent/Designate . - . Commenls Signature Date . Waxyth - to? [gang (0?31? l?f 2a meow-ow?xkk? low?!) manage/MOM . [o 2/1 3-D (Lil?gtg/JIL 5/ Wf Continued/Additional Comments by Regional Director/Designate Comments I SIgnalure mam/[mi ?hwy 1LmidteMM VJ . I I . V'va . Date mambqun: Original - Ragimal Director {Only for Regional DilodafRavicw) -. Copy Inn-law File CSD 075-100 (10104) 5'21?) I - I 600642 ,r Ontario Ministry of Community Safety and Correctional Services Segregation Decision/Review mine i Protective Custody Institution Security Ci Medical Inmate Request 7 - - Ottawa-Carleton Dentetion Ce?ntre Name (Last. First. Middle) w, ES Identi?cation No. - Reasonte) for Segregation Date of Segregation 08/06/201 4 Inmate advised of reason for segregation Inmale advised oiopporluntly for Interview with Superintendent Ci inmate advised of opportunity to make oral or written submissions inmate'waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of SWM Date 01! RV Superintendent Decision (This section must be completed within 5 days of the inmate'iplacemeni in segregation) Inmate Submissibn Superintendent Decision Release from Segregation Continue Segregation Reasons: - .2 . Admitted to Seg for. Name of Superintendent/Designate Pat Barnes. NDeputy Superintendent .r Signature ot-Superintendent/Designate Date t5 I . . Segregation Rewew (inmate's segregation to be reviewed every 5 days. interview with inmate to be conduaied every 30 deg) Inmate Submission . p? Release from Segregation El Superintendent Decision Continue Segregation Reasons: DAY: MI LON Name of Superintendent/Designate (Print) Signature-of uperintendenUDesignate Dale {Dietarth I . Supplementary Report for each Subsequent 30 Day Period (use revenge offarm for additional comments) - Comments Superintendent/Designate Signature Date 5.1 5.2 m) can '075-100 (10104) 000643 y. i?trict Administrator Review Page 2 Continued Segregation Supporled Comments Not Supported - Name of Dislrict (Print) Signature of District AdministratorIDeslgnale Dale I beam - Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . Comments Slgnature Date Continued/Additional Comments by SuperintendentIDesignate . Commenls - Signature Dale - A Q, . 04?3? ?70 bun? I/k?l 7' 7f . [a 6-0" 3" mm I (5m weir} 55% . ContinuedlAdditional Comments by District Administrator/basic nate Comments Signature Date .g 9,-an Mamie 11.5 01A 1 Ale-? arm/- 94 1440 Ame/'Wm I a? fir/arm .- D.I\ul\ 7M 1/ A _s.21(1) CSD 075-100 (10104) Original - Drama Administrat- COpy - In 1w rWMAdmlnislmtor no?) ?ll: . 000644 ME Segregation Decision/Review EpOnt?rio lg iDs-eroeiQ-ot cone 2( Name (Last' First. Client identi?cation No. j/ - tor segregation Date oi Segregation Protective Custody Institution Security Medical Inmate Request 06 oat 2014 inmate advised of reason ior segregation I I Inmate advised-of opportunity to make oral or written submissions inmate advised of opportunity for interview With Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignale (Print) Signature of nlen UDasignate Date Piouffe 06 Oct 2014 Superintendent Decision (This section must be completed within 5 days of the inm?s p?oegieni in segregation) inmate Submission - . Superintendent Decision Release irom Segregation . El Continue Segregation Reasons: (L CA.) (W me of SuperintendenUDesignale tPrint) Signature of EU 'niendenUDeeignete Date Segregation Review (inmate's to be reviewed every 5 days. Interview with inmate to be conducted eVery 30 days) inmate Submission - Su enntendent Decision Release from Se re aiion El Continue Segregation . Reasons: I [In Ca ?drxo 09-] Name oi Superintendent/Designate (Print) . perintendentiDaslgnate Date Supplementary Report for each Subsequent 30 Day Period (use reverse offomi for additional comments) i Comments SuperintendenllDeslgnate Slgnature Date MMIddeyy s.21(1) cso 075-100 (10104) 000645 ?nk) - Z?'Ontario Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name: OTIS Number:__ Inmate Written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: I (To be Icompleted by Sergeant) Inmate Signature: Date; OJ - Witness - M0 (agld - . I WitnessSignature: s.21(1) 000646 '1 Regional Director Review Page 2 Continued Seg?gallon - {22/ Supported Comments art/writ uLw Wan/4an . - ?Not Supported amaze We ?aw/f - Name of Regional DirectorIDeslgnate (Print) Signature of Regional DirectorIDeelgnate Date ?(Be/m at Kan, 7 My Q6 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date _ContinuedIAdditional Comments by Superintendent/Wilma 7 Comments Si nature Date ?g 1.0 W- 33? (Mr lorat- H4 20 lr\ Leweckk?? gamma <24 /g 9g Jebe 94; 1o - 3! - 20 mwm?f?a's'h'lok pa @1K/Lalmtj a" l9? Continued/Additional Comments by Regional Director/Designate? Comments Signature Date cso 075100 (10:04) _Dielributlon: O?ninel - Regional Director (Only forRaglanatmreotorRevlew) Copy - Inmate Filo 000647 ?ag .. - FA?ng . f; cjlc?gbggegregation Decision/Review Ontario Ottawa?Carieton Dentetion enlre Time (Last. First. Middle) . Client identi?cation My . Reasonts) for Segregation Dam of segregauon Protective Custody Institution Seourily Medical Bin 9 Request 1-3-2014 gamete advised of reason for segregation . El ate advised of opportunity to make prai or written submissions inmate advised of opportuntty for interview with Superintendent ?aw waives opportunity for Interview with Superintendent Name of SuperintendentIDesignate (Print) Signature ot SupeWeaignate Date Francis Nolet, Deputy Superintendent . I 5? Superintendent Decision ?hte section must be campteted Within 5 days of the inmate's placement in segregation) inmate Submission - . ne'er Su erinlendentDecision? Ci Release from So re 'aiion \12' Continue Segregation Reasons: Admitted to Seg for: incompatibie Name at Superintendent/Designate (Print) . Signature of SuWignate Date Francis Nolet, Deputy Superintendent . I I . I Segregation Review (Inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submleeion . . i . Superintendent Decision Reiease from Segregation Continue Segregation Reasons: DAYeot SuperlntendenUDeeignate (Print) Signature ofS nden estgnele Date - I Supplementary Report for each Subsequent 30 Day Period (use reverse offonn for additional Comments I SupenntendentlDesignate Signature Dale 080 075-100 (10104) 521(1) - . - 000648 7 Regional Director Review Page 2 Continued Segregalion 8? Supported CI Not Supponed Commaan Name of Regional DiredorlDesignate (Print) Signature of Regional DirectorlDeslgnale Dale I K, 3 Kd'h?z; 7 547 Supplementary Report for each Subsequent 30 Day Period {use boitom of form for additional. comments) Commenls Slgnalure Date Continued/Additional Comments by SuperintendenUDesignaie - Comments Signature Data 7 i A . 9713? i 1)?an MIAMKUW LO . . ?7 - la'lf I ag?g 343 "71/ Lem-gawk my .36? 14 ?1?15 300 17? Continued/Additional Comments by' Regional Director/De_ngnate Comments . - . Signature Date MMIddImy In?! I '0 H?l/l? mad . MK ?igfoo/ua/rm-v I I 7 Ail/m, we {?r/iv 7/11/01 [/57/[7Ml? VV 7" Dinitibu?on: Original Regional Dire-dd (Only for Regional Dirador Review Copy-1min Filo . CSD 075-100 (10/04) s.21(1) 000649 1' I Ministry ?i ??mniunuy Safety Segregation Decision/Review PO 'and Correctional Services . ano: FAX lug-ro~tq-~o\ - Institu' Ottawa-Carleton Dentetion ntge/ Name/(Last. First, Middle) sonta) for Segregation 7 Protective Custody IE Institution Security Medical inmate Request Izr?mato advised of reason for segregation grime advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent inmate waives opportunity for interview with Superintendent Name ofSuperintendenUDesignale (Print) Signature of 'ntan signale - Date Francis Nolet, Deputy Superintendent . - I 06-10-2013 Superintendent Decision (This section must be completed wi?rt'n 5 days of the inmate's placement In segregation) Inmate Submission Date of Segregation 06-1 0-201 3 - . 1 Superintendent Decision CI Release from Segregation Continue Segregation 7 Reasons: - Admitted to Seg for: security concerns - Name of SupenntendentlDesignate (Print) Signature of ri tendenUDeaignate Date Francis Nolet, Deputy Superintendent Fl ld' Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission - Superintendent Decision El Release from Segregation Continue Segregation Reasons: -IDAY: .- 5 - . Name ofSuperlntendentlDeeignate (Print) . - . Slgnature Wsignate Date (Clam Sd/(3 Supplementary Report for each Subsequent 30 Day Period (use reverse errenn for additional comments) Comments Superintendenthesignate Signature . Date . 7 _7 . - 7 521(1) can 075-100 (twat) 000650 s.21(1) Page 2 R?e'gional Director Review i Segregation Supponed El Nol Suppoded C?mmanls /m47454 A7 I N?ame of Regional DIreclor/Deslgnale (Print)l Signalure of Regional DirectorIDesignale Dale I K. penis 7 Simplementary Report for each Sugs?quent 30 Day Period {use bottomof? form for additional comments i' Comments . Signature Dale MMIddImy . i Clontinued/Additibnal Comments by-?SgperinlendenUDesignate - Commenls' I Signature Dale . . I HMS - vacuum) hum) ~scouwf?r I lo? ?1610 r?cciuwlu H. 1 f0 ?19/ w?f gar n? . - (LC/dz; v} \wiing we.? i . i . rz/CuslnB I filo FCC/bung \Nx UPJC '30:?an 1 i . Continued/Additional Comments by Regional Director/Designate 5 Comments Signature. Dale 5 ZWI I M?u?lm a/ l/Xm21441'} Vaqu #11,;th .1144 ?ax/Ma.) {.115/ MA. (W4C Esp-4? ,n i Jm?rv 7 i . 1 1445/29/13 AA i i ciao Onginnl Regional Diteclor [Oniy [of Regional DiradarRavfew] Copy - lnmala FilB 000651 by.) I 2* Ontario Ottawa-Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:_. OTIS Number:_ Inmate written submission for 30 day segregation review: ullnuluh Ul?l lUr 3U [Jay (To be completed by Sergeant). lnm'ate Signature:_ 'Date: i - Witness-Name:? Cir/73mg?? . . I. 7 . Witness Slgnature: s.21(1) 000652 . Segregation Decisioaneview Ontario FAXED [togaIOdLJ?O't Institution I {1109 Ottawa-Carleton Dentelion'Cen Name (Last. First. Middle) Cllenl Identi?cation No. I Reasonts) for Segregation - Date of Segregation PfOlediVe Cuslody mum!" Security Medical Inmate Request Gama/2014 Inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity [or Interview with Superintendent inmate waives opportunity for interview with Superintendent A . . Name of SuperintendentlDesignale (Print) Signature of SuperintendentIDaaignate Dale 09/03/2014 Superintendent Decision (This section rnusr be compiered within 5 days of rho inmars'ggracament In segregation) inmate Submisslon Superintendent Decision El Release from Segregation . 5' Continue Segregation Reasons: . Admitted to Seg for:_ c; Mfo Name of SuperintendenUDeeignale (Print) Signatur SuperintendentlDesignate . Date Pat Barnes. A/Deputy Superintendent I . A 09/0412014 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) .Inmate Submission Superintendent Decision Release from Segregation 12/7 Continue Segregation Reasons" DAY: Name oiSuperintendenUDesignate (Print) Winnie Dale WS/mm-f - CHE-- no Supplementary Repdrt for each Subsequent 30 Dy Period (use reverse affarm Comments . SuperintendenUDeeignaie Signature Date . i 5.21m - . i 030 075-100 (1DIO4) 000653 Page 2 Regional Director Review Continued Segregation Supported El Comments Not Supported C?s-mm ?tm't apt-13>? W71 Mm??/rgl, Mtg/15W 6/ ?Name of Regional Director/Designate (Print) Signature of Regional DirectorIDeslgnate Date r. -b?Pvms Km 7W Supplementary Report fer each Subsequent 30 Day Period (use bottom of form for additional comments) Cornments? - Slgnalure Date ande ContinuedlAdditional Comments by Superintendent/Designate . . "Comments Signature Date . ?1 :w maker- ,1 Hm 4.. ?Lg, ?(Mn M1395 I Dueter . 56/ rim /o'r (.007 0mm J- ContinuedIAdditional Comments by R_egiona Director/Designate I - Comments Signature - Dale - . WI '40! A1 mm 42?? "r . . 7 s.r'Vi1'R DIalrlhullun: Origlnal - Regtonal Director (one rarnegjanamreaor Review) . copy-Inmate ?le . 5.21 (1 CSD 075-100' 10/04 000654 7 why?D. 9" Ontario - s.21(1) Ottawa~Carleton Detention Centre . INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Name; OTIS Number:_ I Inmate written submissionfor 30 day segregation review: 'lAnm'ate' Oral Submission for 30 day Segregation Review: (To be completed by Sergeant) ,?lnm'ate Signature; ?1 Date: ?gr/3 Jar? ?Wltness'Na'mef i - Witness Signatur - 000655 92 Ontario I Ministry of Community Safety and Correctional Services Segregation Decision/Review - Institution a-Carleton Dentetion Centre Name (Last. Firsl, Middle) Ef?e Client Idem Reason(s) tor Segregation . Protective Custody E?l/nstitulion Security Medical inmate Request Date of Segregation 09/01/2014 anmate advised of reason for segrega?on ?l?ate advised of opportunity for interview with Superintendent m'rnate advised of opportunity to make oral or written submissions Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of SuperintendentiDesignate Dale 9 '2 00/01/2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) 'Inmate Submission Superintendent Decision Ci Release from Segregation Continue Segegation Reasons: Admitted to Seg for: ?1 Name of Superintendent/Designate (Print) Signature of Superl ndanttDesignale Dale 09/02/2014 Pat Barnes, AlDeputy Superintendent . . - - Segregation Revrew (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days} Inmate Submission Superintendent Decision Ci Release from Segregation Lil/c Continue Segregation CSD 075-100 (10/04) Reasons: DAY: (J: cum-1 ix Nan?of upenntendenuoesignate (Print) Signature ofSuperintendentiDeslpnale Date r/ (i If Supplementary Report for each Subsequent 30 Day Period (use reverse orrarm for Comments SuperintendenttDeslgnete Signature Date . - s.Nl_R 7? 521(1) 000656 Page2 I Regional Director Review Continued Segregation 12/ Supported . Not Supported Comments - . - Name of Regional Directorloesignale (Print) I .Signalute of Regional Director/Deslgnale Date WHY I 7 1?15 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Slgnature Date . MMIddImy Continued/Additional Comments by Superintendent/Designate Comments . Signature - Date . . - . 3C was atlcaViva-sth LiUi?Kb'IwreAsd I .3. - . I 3/4/1/ Continued/Additional Comments by Regional Director/Designate . Comments . Signature .I-I I Date I I I ?@414 5/41, I '7 I '1 4, ??fth/t) 1 1/14,? MA: ,44441544544DIsMbutlnn: Original - Regional Director {My far Regional! Director Review) 4 S-NIR Copy - Inmate Fin .1 080 075-500 (10104) 821(1) 000657 .t . v: Ministry ?Community Safe? I Segregation Decision/Review . 2 Ontario and CorrectlonalSemces ms4o?jukol i?gee mom, . new cementet? vi CWIOH No. . Name (Last. First. Middle) Reagents) tor Segregation . - Date of Segregation Protective Custody Institution Security . Medical inmate Request 1?8720.? Bf ate adVised of reason for segregation I mmale advised of opportunity to make oral or written submissions ?aw advised of opportunijy tor Interview with Superintendent Emir-new waives op ottunity for interview with Superintendent Name of superintendenUDeslgnale (Print) Signature of Super' nilDasignale te Francis Noiet, Deputy Superintendent i4 8 I I 7 I Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission - . WW Wm, in mm? Superintendent Decision El Release from Segregation CY Continue Segregation Reasons: Admitted to Seg for: incompatible. Name of SupenntendentlDesignale (Print) Signature of Superi tl ignete ate Francis Nolet, Deputy Superintendent . 8 I 4 . . Segregation (inmate '3 segregation to be reviewed every 5 days. Interview with inmate to be condu?ied every 30 days) I inmate'Submission . . Superintendent Decision Ci Release from Segr_egation iQ? Continue Segregation r?ncom/Qabwf me of SuperintendenUDesignate (Print) Signature ofSUW?t/Designate - Date I . WNW . join/3W4 Supplementary Report for each Subsequent 30 Day Period (use reverse ofi'orm for additional comments) Comments I Superintendent/Designate Signature Date s.14t2iidi I s.21(1) CSD 075-100 (10104) . 000658 Pege 2 Regional Diiector Review Not Supponed Conlinued Segregation Supported Commems Name of Regional DirectorlDeslgnale (Print) Signature 0! Regional DIreotorIDesignate Dale 7Wr9?j Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signaluro Dale Continued/Additional Comments by SuperintendenVDesignate Comments . Signature Date . 9:7! hum? Wok? for 9? (ff??1 3480 ng\ Bum/14? . a a . . 735$ Kn!ng . 309 rift-49m; 07/ ContinuedJAddilional Comments by Regional Director/Designate - - Comments . Signature - - Dale ax I ZMJ/?jggz - 51/910?- 7 5 S.NIR 0mm: - Regime! Director (OnlyforREgional'DndorRavwa . Copy - Innate File - s.21(1) CSD 075-100 (10/04) 000659 Ontario Inmate Name:- Ottawa-Carleton Detention Centre INMATE suamugswu FOR 30 DAY SEGREGATION REVIEWS OTIS Number:__ inmate written for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: (Tobe completed'bysergegnt) Cw 0454'er my m/W 074 @7524! Witness Name: Witness Signature:- 4 .gg?i C255 i?d?z; A?g?ZAgg?7 is.21(1) 5.21pm) Date: 000660 Segregation Decision/Review Ontario: dcoc? Name (Last. First. Middle) Client Identi?cation No. Reasonis) for Segregation - Date of Segregation El Protective Custody Institution Schrity Medical Inmate Request 1010412014. Inmate advised oi reason for segregation Inmate advised o! opportunity to make oral or written submissions inmate advised of opportuntiy for interviawwilh Superintendent Inmate waives opportunity for Interview with Superintendent Nlhme Signature ofSuperintendenU ignale Date GARNETF 10-04-2014 I Superintendent Decision (This secllortl must be compteted within 5 days of the inmate 'sglacemeni in segregaiiOn) Inimale Submission Sttporintendent Decision El Release from Segregation COnllnue Reasonsucf7 Name of SuperintendentlDesignate (Print) i 1 Signature ofSuperinle ntlDesignale Dale 3 ti?kua~ci . I Segregation Review (Inmate's segregaiian to be reviewed every 5 days. Interview with inmate to be conducted Wear 30 days) Ininate Submission - . I i Ltperlntendent Decision Re ease from Segregation Continue Seg?galion i3550n52? I am; ?elder? - Name of Superintendent/Designate (Print) Signature otSu lendenUDasign . Date I - . . Wetter . - Supplementary Report for each Subsequent 30 Day Period (use reverse offarm for additionetoommonts) - Comments superintendenUDesignate Signature Date a II It - i csoors-too (10:04000661 I I Regional Director Review . Page 2 I Continued Segregation Supported - Comments Aged; Mathews {6 gel?aw. Not Supported PM Name of Regional Signature of Reglonel DIreclorIDesignata Dale W2 3 IgGh?f?x 7 NW 1% Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments 7 Signature Dale Continued/Additional Comments by Superintendent/Designate . Comments Signature Date - I Mhum?nnyr . - - 1'0 (M'rdmv?a?/ "b R.) 47 Lo (la-JO )0 ?gg/ uxrw~x Qua?- Comments by Regional Director/Designate Comments - Signature Date - HM [Ml I f? c/ - 5.21m CSD 075?100 (10104) Dlst?butlon: Orialnai - Regional Director (Only hthna} Director Ravioli!) Copy - lnmalo File 000662 . . . Ontario - . I . . Ottawa?Carleton Det?ntion Centre INMATE SUBMISSION FOR 30 DAY SEIGREGATION REVIEWS Inmate Name:_ OTIS Number; Inmate written'submission for 30 day segregatlbn review: Inmate. Oral Submission for 30 day Segregation Review: be completed by Sergeant) I /u,m;a1ca . Inmate-Signature: 2" Date: it 2d 250151.917 Witnes?s Name: I - . Witness - . . 000663 a" Ontario- (O .itz?o'i Segregation Decision/Review 0.0.0.0. N?Fme (Lasl, Firsl, Middle) Client ldenlilicalian N0. 2 RhasoMs) [or Segregalion Dale of Segregation Oct-0144 Inmate advised oi reason for segregalion Prolecllve Cusiody Institution Sec'urily Medical El lnmale Request lnmale advised of opponunily to make oral or wrilten submissions inmate advised of opportun?liy' for interview with Superintendent inmate waives pgportunity lor Inierview wilh Superintendent N'aMe of SuperintendenUDeslgnale (Prinl) i Slgna Sup rinl?pde eelgnale Date I . t. S. Cloutler 10/01/2014 I . . . i i Supenntendent Decreron (Thisseclrari mus! be completed wilhin 5 days on nmale's placemenl in segregation) in:male Submission S'upen'nlendenl Decision El Release from S_egr_egalion Conlinue Segregaliun Reasons: - Placed in Pod A for security reason's due to-media coverage regarding charges . i - . Name of SuperintendenllDasignale (Print) Sig lure fSup rinien s" . Dale Slgt. S. 017% I 001431414 In'rnale Submission i Segregation Review (inmate?s sag-raga i I lion lo be reviewed every 5 days. In! aw in . male in be conducted every 30 days) UJ uperintendenl Decision El Release from Segregalion Continue ID easona: g-eou'nm Dale Wuperinlendentmesi naie (Prinl) 3 -.. i {014,14 U107: r/ ID (9 Supplementary Report for each SUBsequent 30 Day Period (use reverse arronn for aWIcommenls) Commenls i A SuperintendenUDesignale Signalure Dale . i i I _5 den-075400 (10:04) 000664 I Page 2 Re ional DirectorReview . Cot ntinued Segregation Supported Not Supported ?C?:?mments - N'pme of Ramona! DirectorlDeslgnat? (Print) Signalure 0t Regionat Director/Designan I Dale . i . Rep0rt for each Sule-??ment 30 Day Pertoyuse bottom of form for additional comments Comments: - Signature Dale - 7 I Continued/Additional Comments SUperintendenUDesigmte - Commonlsi I Signature - Dale - I . Lb uwwa?hl 10 1/Semwb? fA??a-l?l/ a [0?21"Continued/Additional Regional Director/Designate 7 . . . Comments; Signature Date 1 Mun/om Musing ow; 714m"; Lj' l/ Lawful Lola?;- 2 . 7 - fat. aux/f 956/044; $0451? . g?l/z ;M?lg/4- I I i - i Distribution: 521(1) coo 7 1 . 000665 .i?ye . - . 3* Ontario Ottawa?Carleton Detention Centre INMATE SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS inmate Name:_ OTIS Number; Inmate written submission for 30 day segregation review: inmate Oral Submission for 30 day Segregation Review: I (To be completed by Sergeant) .lnn-i'ate Signature:__ Date: 3 01L . .s.21(1) Vthness Name: Witness Signatur ?000666? a I to . . - MWSW ?f C?mmumiy Safety Segregatlon Decreroanevrew 1" ,1 1) - . Ontano and CorrectionalSowlcesFA m9: 0' Ottawa; rieton Denteuom Name (Last, First, Middle) Client idol '?caii o. Reason(s) for Segregation Dale of Segregation El Protective Custody Institution Security Medical El Inmate Request 10,0120? Inmate advised of reason for segregation Inmate advisedot opportunity to make oral or written submissions Inmate advised of opportuntly torinlervlew With Superintendent Inmate vraivee opportunity for interview with Superintendent Name of Superintendentipeeignale (Print) Signature of SuperintendentiDesignate Date - Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission Simenntendent Decision El Release from Seg?gatlon 3 Continue Segregation Reasons: Admitted to Seg for: tested positive for TB. Waiting for may - Name ofSuperintendent/Designate (Print) - Signature of SuperintendenUDesignate Date Pat Barnes, AIDeputy Superintendent Segregation Review (inmate?s segregation to be reviewed every 5 days. Mien/low with inmate to be conducted every 30 days) Inmate Submission - Superintendent Decision El Release from Segregation Continue Segregation Reasons: - DAY: 5 . - -me. .3 Ace. .M2np3uperintendenunesl nale (Print) - Date (.4 I /o (105' i?t? Supplementary Report for each Subsequent 30 Day Period {use reverse ofform roradaiQongi?amments) Comments SuperintendenUDesTthate Signature Date I s.21(1) . CSD 075-100 (1DIO4) - 000667 Page 2 Regional Director Review - Continued Supported [3 Not Supported Comments i . . a Name of Regional Director/Deslgnale (Print) Signature of Regional DlreclorlDesignate Date (?New 7W/y Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature . Dale Continued/Additional Comments by SuperlntendentlDesignate - . Comments - Signature Dale . . . - fa?yfue l0 m) alas -r a; 10: u? LHL if WNLJ 0?05 may,ng (Y Tower/9? 39' WAC 02h; 93? [9 3b do?C Continued/Additional Comments by Regional Director/Designate ?Comments . Signature - pate . . I ?r I 7/77 Jayme 1/4140" 4 ?g?gaum 4'th 545 - [54$ LK Dlalribullon: Original - Regional Dirednf (Only forReglonafDlredor Ram?qu Copy - lnmalu Filo cso 075-100 (10104) 7 000668 r5.- - p?Ontario Ottawa-Carleton Detention Centg SUBMISSION FOR 30 DAY SE-GREGATION REVIEWS Inmate Name:_ OTIS Number: Inmate Written submission for 30 day segregation review: Inmate Oral Submission for 30 day Segregation Review: 1? (To be completed 'by Sergeant) lnmate-Signature:_ Witness Name: Witness Signatur s.NlR . 521(1) 000669 sQ21(2)(f) lug ion u~or I . Segregation Decision/Review Ontario FME . e5 0000 Name (Last. First. Middle) Reasonte)I lor Segregation Date of Segregation Protective Custody Ci Institution Security Medical El Inmate Request 04 Get. 201 4 Inmate advised of reason for segregation A Inmate advised of opportunity to make oral or written submissions inmate advised of opportunliy for interview with Superintendent El inmate waives opportunity for interview with SD erintendent Name of SuperintendenUDeeignale I Sing?de ale - Date Plouffe 04 Oct 2014 I Superintendent Decision (This section must be completed within 5 days of (he inmate's piq?nientgi segregation) Inmate Submission I . Superintendent Decision CI Release from Median l2". Continue Segregation Reasons: 5 A05 me of SuperintendenlJDesignale (Print) I 0 Signature of perintendenUDeslgnate Date Seg?gation Reutew (Inmate's segregation to be reviewed every 5 days. lniervlew with inmate to be conducted army 30 days) inmate Submission . Superintendent Decision Release from segregation Continue Segregation Reasons: Name of Superintendent/Designate (Print) I Signature of Supe entIDeelgnaie Date Dif?oeuit ,10'4? Supplementary Report for each Subsequent 30 Day Period (use reverse of form comments) i Cements SuperlnlendanilDesignaie Signature - Dale - - s.21(1) cso 075-100 (10104) 000670. Regional Director Review Page 2 - Continued Segregalion Supported I - Not Supported comments Vang/?t ?yea?v.5 I Name of Regional DirectorIDeslgnale (Print) I Date Slgnaiure of Regional Director/Designate ,(cbz?m?s 26%? 7443/1?? Supplementary Report for each Subsequent 30 Day Period (use bottdm of form for additional comments Comments Signature Date Continued/Additional! Comments by Superintendent/Designate Comments . . Signature - Dale - I i0 We! db; {0?1-94 1?1 i< NJ Am; rb'l?zvf/ rm; 01013-34-157 30 in Continued/Additional Comments' by Regional Director/Desigmate Comments . Signature Data H44 [mod 490 in 614521(1) cso '075400 (10:04) DIsIribulion: O?gino! - Regional Director (Ono! rorRogionar Review) Copy - Inmate FIIB I 000671 l, . pr, . If? Ontario. A Ottawa-Carleton Dete'ntion Centre INMATE SUBMISSION FOR 30 DAY REVIEWS Inmate Name:_ OTIS Number:_ Inn-Ian wriffpn for an dau enurpna?nn rpuiaw- Inmate' Oral Submission for 30 day Segregation Review: I I (To be cpmpietedby Sergeant) InmateSlgnatur? Data?f?g bio - 000672 .v 'arlo Ministry of Community Safety and CorreCtional Services Segregation Review OvermGO Name (Last, First, Middle) 7 - Client identification No. . .. DateotSegregation 07/24/2014 Reason(s) for Segregation Inmate Request '1 Total'paysin Segregation 60 days I Inmate Request Date Reviewed Sept 27 2014 9 I, I 'Choose'ranitem; - . I. . Signaturepf DesignateE Choose Abilityt cope'in GP. Setting Choose Ability to cope in PC setting Choose ifNowhy! Peer issues -. a- :5 4 . -- rtg?glmasi?ia, sail - A 1, lfNoWhy 'Peer issues Who is Involved in Plan of Care 7? . Extent 6r InvoIVement (Select all that apply) - Health Care. Unit No serioUs health care issues - .Wbrkel - . Seen regularly by the social werker Choose an item. Choose an item} Choose an item. Choose an item. 'Attempts to Reintegrate This inmate'was transferred to Brantford duelto his peer" issues at HWDC. The inmate had issues at Brantford as well._ The inmate refuses protective custody status at this time; Segregation supported at this time. .1 - Superintendent Decision Release From'Segregation El Continue Segregation/E" SuperintendentlDesignate Name (Print) Torn Bradley Superintendent/Designate Signature - . DateISept272014 HWDC 07-2014 521(1) 000673 a Ontano Ministry otCommunity Safety and Correctional services . 7 Segregation Review/Over 60' Days Name (Last, First, Middle) Client Identification No.? Date _of_ Segregation 07/08/2014 Fleason(s) for Segregation Protective Custody TotalDays in_Segregation '60 days .lnmate Request Date Hevi?tived (Select all that apply) Choose an'item.. Signature 'of Designate Choose an . Choose . .easo Peer issues .7 -- -- Choose Peer? issues Ability to-cope in PC Setting If No Why Who is in Plan olCare Extent of Involvement (Select all that apply) Health CareUnit No Serious health care issues Social Worker, Choose an item. Seen regularly by thesocial worker - Choose anitem. Choose an item.? Choose an item. Attempts to Reintegrate supported at this time. This inmate was previously housed on a PC un it but had issues with his peer group. Segregation Superintendent Decision . Release From Segregation El Continde Segregation Tom Bradley Superintendent/Designate Signaturm Date Sept27 2014 s.21(1) HWDC 07-2014 000674 __._Ministry of Community Safety-and Correctional Services .- Segregation Review Days Name (Last, First, Middle) - Client identi?cation No1 f- I Detect-Segregation 7 Segregation lnstitution Security -1- I Total Days in segregation 60 days (Selectallthatapply) Choose an item. - Date RevIeWedr' i Sept 2014 Choose ?aniterhl: ,7 ., Signature of DeSignate"? 7 Choosean item. a r: - mt - Ability to cope in GP Choose Adrn?inistratiye'seg'regation . Ability to cope in PC Setting Chgose If No Why Who is in Plan'of Care I Extent of Involvement (Select?all that apply) Health Care__Unit i 3? Nos'er'ious health carehissUes SpCi?IIWOfker . Choose an item. Choose an. item; Choose Ian'item. 3 Choose an item. Attempts _to Reintegrate Superintendent Decision Release From Segregation El Continue Segregation Superintendent/Designate Name (Print) Torn Bradley SuperintendentlDeslgnate Signature - I Date Sept'2l_7 2014 5 14mm) . HWDC 07-2014 000675 .0. Ministry 0f'C0rnmunityl Safety and Correptional Services SegregationBevi?w9v?r Pal/? . client Identification No._ Name (Last, First, Middle) 9311/1391? 420 09/2712014 - Date "o'f'ISegregation 3 - TotaliDa'ys in Segregation a Date Retriewed . "Signature of Designate Reason(s) for Segregation InmatelFl'elquest Choose an "item. . (Select all that apply) I . Choose anlitem. ?hoosean item. ty-to'c'ope in GP Setting. No Ability-to-c?ope Setting No' lfNoWhy. ltNoWhy Peer'issues 51 Extent of_ Involvement Who is Involired' in' Plan of Care I No significant health related'i'ssues' Health Care Unit Social Worker" . Choose an item. '5 2' (select. all that apply) -- lsreviewed?consistently? Choose an . Choose an Choose an item. -- Attempts to Reintegrate This inmate wishes to be by himself. Inmate states that he'lears . - tor ms sater in GP or PC due to his notoriety. Segregation supported at this time.) - v- . Continue Segregation Superintendent Decision Release Frorn Segregation El . 'l'orn Bradley? Superintendent/Designate Name (Print) Superintendent/Designate Signature . Date 99/27/2014 s.1 's.21(1) HWDC 07-2014 000676 i . Eigis'tfy "segregation'Decision . - orrectiona ervices I. - 1. ?Ontario .. .. .v - an? 7 - Institution Hamilton Wentworth detention Centre Client identification No. - I. Date ofS?egregatlon 05/08/2014 Reasonts) forSegregation 3 Pr?tebtive Cusmdy institution S?c?ritv D?Medical ?Ellnmate Recluest a inmate advised of reason for segregation . - . Inmate advised 0f opportunity to matte oral or written submissions Inmate advised of opportuntiy for'i'nterview with. Superintendent; Inmate Superintendent NarnleSuperintendent/Designate (Print) . - 1 Signature'pfSupen'ntend Date 5 - . 7 05/10/2014- 7 I 3:71Superintendent (T his section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission . .. .. 1" - . Inmate wishes to be relocated to a GP unit . I I Superintendent Decision El Release from Segregation Continue segregation Reasons: . . - 4"1- - a - . .T._his offender seriously assaulted Segregation supported at this time. Name of Superintendent/Designate (Print) . I r. 3 Signature ofSuperintendent/Designate I Date. 05/1 212014 . Torn Bradley S?greggtion Review (Inmate 's segregation to be reviewed every 5 Ida interview with inmate to be conducted every 30 days) Inmate Submission - .Inmate Wish-95.10 be relocated to?a GP unit Superintendent Decision El Release from'Se'gre'gation 5- Continue'Seg?gation Reason?iz I: if kl 2 I'm- I - This offender seriouslv assaulted Name of Superintendent/Designate (Print) - Signature of Superintendent/Designate . Date Torn Bradley 2} 3 I I. 06/10/2014 Supplementary Report for each Subsequent 30 Day Period (use reVerse'offonn fora'dditionai'comments) Comments - superintendent/Designate Signature . - Date . .- . y. - .. . . segregation still July 09 2014 supported at this time. Segregation. still I August 12 2014 supported at this time. I cso 075-100 (10/04) 000677 Page 2 Regional Director Review - Continued Segregation El Supported El Not Supported Comments . . Signature of Regional Director/Designate Date Name of Regional Director/Designate (Print) Supplementary Report?f0r.eacl1. SUb'sequent 30 Day Period. (use bettom of form for additional, comments i Comm'"nts . .. Signature Date - w? '1 . - *g?e?iatffm??ar =e rt' Chiral?5?s??!ng ?lQiZU?M?i?g . sept 27 2014 Continued/Additional Comments by Superintendent/Designate Comments - Signature Date . - . i . Continued/Additional Comments by Comments Signature i '1 Date- - 3 Distribution: Original - Regional Diredor (Onlyfor Regional Director Review) Copy - Inmate File CSD 075-100 (10/04000678 Ministry of Community Safety Correctional Services, ,v Segregation Decision/Rev? g) Ontario . Institution Hamilton Wentworth detention Centre Name (Last, First,.MilddIe) Client identi?cation No. FReason(s) for Segregation Protective Custody Institution Security El Medical Inmate Request 05/16/2014 Date of Segregation Inmate advised of reason for segregation A ?7 Inmate advised of opportunity to make oral or written submissions Inmate waives opportunity'for interview with Superintendent IE Inmate advised of'opportuntiy for interview with Superintendent I .- NameofSuperintendent/Designate (Print) Signature_ofSuperi _nt[Deslgnate . Date . .. 05/19/2014 Tom?l?radlev . . . r. - I Superintendent Decision (This section must be completed within 5 days of the inmate's pig-150111950" segregauoa; Inmate Submission Inmate requests segregation due tolnumerous peer issues Release from Segregation Continue sema?on Superintendent Decision - IE Reasons: - Inmate claims to have numerous peer issues. the offender has been'offer'e'd to BB protective custody unit and has- Date Nameot Superintendent/Designate (Print) I 05/23/2014 refused. Signature of Superinten esignate Tom Bradley Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Inmate requests segregation due to numerous peer issues Superintendent Decision Release from Segregation 8 Continue ReasonsInmate Claims to have numerous peer issues, the 'offender has been offered protective foustody unit and has refused. Name ofSuperintendent/Designate (Print) Signature of Superinte nt/Deslgnate' Date Tom Bradley i '1 0 06/16/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse of fomi 1. Comments - . - Superintendent/Designate Signature Date We are trying to reintegrate this offender to 33 unit. The inmate continues to be reluctant to reside in 3B unit. Segregation supported until the offender complies. July 17, 2014 .This offender was relocated to ZBL'unit'in an attempt to try to reintegrate the offender onto a regular PC living unit. Aug 15 2014? 's.21(1) 030 075-100 (10/04) 000679 Page 2 Regional Director Review Continued Segregation, El Supported El Not Supported Comments . Name of Regional Director/Designate (Print) . Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments -. Comments . . Signature - Date Sept 27 2014 Continued/Additional Comments by Superintendent/Designate Comments - Signature Date - Continued/Additional Comments by Regional Director/Designate Comments Signature Date Original - Regional Director (Only for Regional Director Review) Copy - inmate File CSD 075-100 (10/04) 000680 I I 'Ministry of Community'Safety - segr?gatiio'n Decisioi - &Correctional Services - - - . t. - - Ontario -. Institution, "1 Hamilton Wentworth detention Centre Name (Last, First, Middle) II - I . - Client Identification No. ?7 . -. .I - Date ofSegregation. Protective custody. - Instit tion Inmate Request t. i Augaa 2.014 Inmate advisetil of reason for segregation -. inmate attyisedotooportunity to make oral or written submissionin . lnmateiac-tvisieci'ot opportuntiytor interview with'Superintendent 7 . Inmate obportunity tot. interview with Superintendent Name of Superintendent/Designate (Print) s. Date Tom Bradley - ?Aug 36 5 Superintendent Decision (T his section must be completed within-:5 days of the inmate's placement tn'segregation) - - nmate SupmiSsion -- - Inmate requests to go toa GP unit - .tI Superintendent Decision El Release from Segregation - IE Continue Segregation Reasons:_ - . .: was charged with attempImurcIlerI Segregation, supported at this time. - Name I Signature ofIsuperintenqenth?Designate I I .Date I Tom'Bradley . I . i i I - Sept 02 2014 . Segregation Review (Inmate?s segregation to be reuieWeoi every 5 days. Interview' with inmate to be Ico'nducted every 30 days) Inmate Submission - . - . . - - inmate requests to go to a GP unit Superintendent Decision" El Reteasetrom Segregation "Continue Segregation Reasons: I I I. I . was energed with Segregation supportedI atIthis time. - - A i? - Name of Superintendent/Designate (Print) - I I - -..I- - Signature of superintendent/Designate Date Tom Bradley Sept 29 2014 SuF?p'lementary Report for" each Subsequent 30 Day Period (use rte-Verse ofform fora'ti'ditianalcommentsf 7- i Comments . . Superintendent/Designate Signature - Date 7 . .. . w- . 1-77: "17October 02 2914' I CSD 075-100 (10/04) 5'21?) . 000681 Ministry Of Community Safety Segregation 8: Correctional Services Institution Hamilton Wentworth detention Centre Name (Last, First, Middle) Client identification No. - Date of Segregation .2014 Protective Custody institution Security Medical inmate Rjeguest' inmate advised of reason for segregation inmate advisedlof opportunity to?rnake oral or written submissions .E inmate lwaives opportunity for interview with Superintendent Inmate advised of'opportuntiy for interview with Superintendent Name of SUperintendent/Designate (Print) Signature of Superintendenthesignate Date Tom Bradley '1 - Au 09 '2014 I . I I .- - Superintendent DeCISion (T his section must be completed within 5 days of the inmate's placement in segregation) inmate Submission 1 I 5 - Inmate requests segregation for his own protection. Superintendent Decision 1 El Release from Segregation Continue Segregation Reasonsnumerous peer issues Signature of Superintendent/Designate Date a Name of.Superintendent/Designate _(P_ri_nt) August 12 2014 Tom Bradley . A Se'g're'g'ation Fleview (Inmate ?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission l. . inmate reqUests segregation for his own piotection.f - 7 from Segregation Superintendent Decision CI Continue Segregation Reasons: I - . Numerous peer issues. This inmate isa high profile sexual offender. Name of Superintendent/Designate (Print) Signa of Superintendent?Designate Date Tom Bradley - I Sept 05 2014 Supplementary Report for each Subsequent 30 Day Period (use reverse offarin fo'radditionai'comm'ents) Comments . Superintendent/Designate Signature . Date 321(1) 64 STA I cso dis-too (10/04) 000682 Ministry of Community Safety I -- - i i Correctional Services . . Institution g?onta?o Hamilton Wentworth detention Centr Name (Last, First.I Middle) Client Identi?cation No. I Date ofISegregation Reason(s) for Segregation I II . . 06/1 1/2014 Protective Custody Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral pr written submissions Inmate advised of opportuntiy for intenliew with Superintendent. I Inmate waives opportunity for. interview with Superintendent Name of Signature OfSuperintendent/Designate Date June 12 2014 I. ._-Superlntendent Decrsron (This section must be completed Within 5 days of the inmate's placement In segregation) Tom. Bradley Inmate Submission - Inmate wishes to be relocated to a PC unit. Release from Segreggtion -- . . This offender ha Superintendent Decision El Reasons: ?Continue Segregation a very poor institutional historv at HWDC. This inmate was returned n?netmhiatrjc assessment at the hospital. Segregation supported at tIrInIe. Name of Signature otSuperintendenttDesignate I Date Tom Bradley; June 14 2014 I. Segregation Re'View'?nmate?s segregation to be reviewed every 5 days. Interview with inmate to I be conducted every 30 days) Inmate Submission Inmate'wis'hes to be reloCated to a regularPC Unit. Superintendent Decision El Release from Segregation? Continue qu?gation ReasonsThis inmate has a history of problomatic behaviourgThis inmate has a tendency to self harm as his court proceeding get closer. I This inmate is seen regularly by the social worker as well as the? Name of superintendent/Designate (Print) I Signature of Superintendent/Designate Date Tom Bradley . July 14 2014 Supplementary Report for each Subsequent 30 Day (use reverse afform ror additional comments) Comments . Superintendent/Designate Signature Date - . . -7-.. .- ?7 ?if .. . Mde/my This inmate has a history of problomatic/selfharm behaviour. This?inmate has a tendency to self harm as his Aug 14 2014 court proceeding get closer. . This inmate has a history of self mutilation. Inmate'stages of his dangerous offender trial. Segregation Sept 27 2014 supported at this time. I I . 521(1) 030 075-100 (10/04) 521 000683 I I I. I- Segregationbecisipnl I Ontario. - 8: Correctional Services . If . Institutioni'Hamilton detention Centre Name (Last. First. Middle) - I I I CIiIenIt Identi?cation No11:33" IIQateofSIegregation Protective Custody Institution Security Medical El Inmate Request AUQ 3 IE Inmate advised Iof reason torIsegregation j' Inmate advised 6t opportunity to make oral orIvIrritten submissions I I Inmate with?Superintendent Inmate - - I a Signature Superintendent/Designate 'Date Aug152o14 - superintendent Decision (T his section must 'be completed within 5 days of the inmate's placement in segregation) Inmate ?qumisSion Inmate requests to go to a' GP unitI superintendent?Decision Release from ContinUe segregation Reasons: - .. - . ..Inmate has a history of assaults Segregation supported at that time. Signature ofISuperintendent/Designate Date segregation Review (inmate?s segregation to tie-reviewed every 5 d?ys.? interview with inmate to be conducted every 30 days) Inmate Submission - . - .t . . I I Inmate requests to go to a GP unit Superintendent Decision El 'Release from Segregation "Continue Segregation Reasons: I - 1 Inmate has Ia history of assaults Segregation supported at that time. Name of Superintendent/Designate (Print) . . .- Signature of superintendent/Designate. - Date _TomI:3radleym - I . sapt242014 Supplementary Report for each Subsequent 30 Day Period (use reverse foradditionai'comments) Comments Superintendent/Designate Signature Date s.21(1) . 080 075-100 (10/04) 000684 'Ministry of Community Safety . I'Segr'e'gatibn Decision] f;>0ntario Institution 1- ix: U. 4 . - Hamilton Wentworth detention Centre Name (Last. First. Middle). 7 . Client Identification No. - - - Date of Segregation . . 07/24/2014 Protective Custody 'I-n'stitution Security Medical Inmate Request Elnmate advised of reason?for segregation I . I - Inmateadvised ptopportunity to make oral or written submissions? lnrnate withSuperintendent I D-lrir?ate superintendent 7 I - . _v I. Signatur erintenderge?rgite Date. Toni-Bradley -- 07/28/2014 Superintendent Decision his section must be compieted within 5 days of the inmate's placement in segregation). lnmate'Submission 7- . - . -. -. Inmate wishes to go to unit at HWDC Superintendent Decision El Releaserlrom SegEgation Continue Segregation ReasonsInmate has previously been?placed in GP units at HWDC. Inmate has been inv0lved in altercations lat HWDC. Inmate has numerous peer issues at this facility. Nameof Superintendent/Designate (Print) A :7 Signature ofS I erintendent/Designate Date - 07/30/2014 Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate submission Inmate wishes to ?goto GP unit at HWDC Torn Bradley Superintendent Decision Release from Segregation Continue Segr_egation . ReasonsSegregation supported at-this timetor the rationale .. v_ . - Name?of Superintendent/Designate (Print) Signature _of Superintendent/Designate - Date VTom Bradley i Supplementary Report for each Subsequent 30 Day Period (.use'reverse afforrn foradditionaicomments) . Comments - 1' Superintendent/Designate Signature Date 0 a -. - W9 - Sept 27 2014 030 075-100 (10/04) s.21(1) 5.21 2 . 000685 8: Correctional Services - Ministry?fc?mmUHity safety. Segregation DeciSioanevi Ontario: -. . - Hamilton: Wentworth detention Centre NameiLast'First- Midd'ei . Client Identi?cation - -- . Reasonis) for Segregation Date of Segregation El Protective Custody institution Security El Medical El inmate Request 07/22/2014 ihmate advised of reason for segregation I I i - .H- Inmate advised of opportunity to make oral or written submissions . .- . v: - . . - .- inmate advised of opportuntiy for interview with Superintendent . El Inmate waives-opportunityior interview with Superintendent - - - Signature 'of Superintendent/Designate - Date Narneof Superintendent/Designate (Print) . Torn Bradley - - 07/28/2014 Superintendent (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Smeission . I inmate wishes to go to a GP unit Superintendent Decision Release from Seg?amon >2 - Continue Sigregation' Reasonsinmate has previously been an administrative segregation 'offender. The inmate ending 'up causing property damaage to an interview room in the-area: Segregation supported at this time Name Signature of Superintendent/Designate Date Tom Bradley - i. - - . - 07/23/2014 5-.- Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission . - - - - inmate wishes to go to anGP unit Superintendent Decision El Release from segregation Continue SegregatiOn Reasons: I I Segregation supported at this time for the rationale mentioned above. . I Name of Superintendent/Designate (Print) . - . . Signature of Superintendent/Designate Date Tom Bradley 08/22/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse ofform foradditionalcomments) Comments Superintendent/Designate Signature Date .v . Sept 27 2014 . 521(1) 030 075-100 (10/04) 21(2)(f) 000686 P. . i 'Ontano Ministry of Community Safety and Correctional Services Segregation ReView Over 60 Days Name (Last, First, Middle) Client ldentiflcationlNo. Date of Segregation June 06 2014 Fleason(s) for Segregation Institution Security Total Days in Segregation 120 (Select all that apply) Medical Date Reviewed _27 2014 Choose an item. Slgnature of Designate Choose an item. .., . - etting .1. mm No Ability to cope in PC Setting Choose If No Why Who is'lnvolved in Plan of Care Extent of Involvement (Select all that apply) Health Care Unit Inmate has on going issues - Social Worker Seen regularly by the social 'worker Operational Staff Reviewed regularly-by area Sergeant Choose an item. Choose an item. Choose an item. Attempts to Reintegrate The inmate was very disruptive. The inmate feels he should be placed in a dorm. This offender does not meet the dorm criteria at this time. Superintendent Decision "Release From Segregation 'El Continue Segregation A SuperintendentlDesignate Name (Print) Tom Bradley Superintendent/Designate Signature Date October 27 2014 HWDC 07-2014 5121(1) sa21(2xf) 000687 ontano Ministry of Community Safety and Correctional Services - Segregation Review Over 60 Days Name (Last, First, Middle) Client identification No. ?t Date of Segregation June 09 2014 Reason(s) for Segregation institution Security Total Days In Segregation 120' (Select all that apply) Choose an item. Date Reviewed Oct 27 2014 Choose an item. Signature of Designate .Choose an item. I o. dirt. 15 Ability to?cope in GP Setting No Ability to cope in PC Setting Choose it No Why - Security issues Who is involved in Plan of Care I Extent of involvement (Select all that apply) Health Care Unit No medical issues Worker I Seen regularly by the sociallworker Operational Staff Reviewed regularly by area Sergeant Choose an item. Choose an item. Choose an item. Attempts to Reintegrate No attempts at this time. This offender has a history of security breaches within this facility. inmate has a history of security breaches in correctional facilities. Superintendent Decision Release FromVSegregation El Continue Segregation A Superintendent/Designate Name (Print) Torn Bradley A Superintendent/Designate Signature I Date October 27 2014 s.21(1) HWDC 07-2014 000688 I .r Eb . Ministry of Community Safety 7 . Segregation Decision] Review - Ontario 8: Correctional Services Institution Hamilton Wentworth detention Centre Name (Last. First, Middle) 1 Client identification No. - Heason(s) forISegregation - Date of Segregation Protective Custody El Institution Security Medical Inmate Request 10/05/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/{Designate I Date Tom Bradley - 10/03/2014 1 Superintendent Decision (T his section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission i Inmate states he has peer issues in the pc units at HWDC Sugrintendent Decision Release from Segregation Continue Seg?ation I Reasons: . . At inmates request Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date 1 Tom Bradley WE) 10/09/2014 Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Inmate states he has peer issues in the pc units at HWDC '1 Superintendent Decision El Release from Seg?gation Continue Seg?gation Reasons: At inmates request Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Tom Bradley - 11/05/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) .- Comments Superintendent/Designate Signature Date - s.1 s.21(1) 080 075-100 (10/04) 000689 Ministry of Community Safety Correctional Services segregatlon Dee's'onlnewew' g? Ontario Institution - Hamilton Wentworth detention Centre Name (Last. First, Middle) Client Identification No. Reason(s) for Segregation Date of. Segregation El Protective Custody Institution Security Medical Inmate Request AUQ 11 2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions - Inmate. advised of opportuntiy for Interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Tom Bradley Aug 13 2014 I I - Superintendent Decrsron (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission Inmate claims to have peer issues at HWDC Superintendent Decision El Release from Segregation Continue Seg?gation Reasons: . . Inmate appears to have mental health Issues and refuses PC status. Segregation supported at this time. Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Tom Bradiey Aug 15 2014 i . Segregation Review (Inmate 's segregation to be reviewed every 5 days. Mien/few with inmate to be conducted every 30 days) Inmate Submission Inmate claims to have peer issues at HWDC El IZI Superintendent Decision Release from Segregation Continue Segregation Reasons: Inmate appears to have mental health issues and refuses PC status. Segregation supported at this time. Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Tom Bradley a Sept 24 2014 Supplementary Report for each Subsequent 30 Day Period (Use reverse of form for additional comments) Comments Superintendent/Designate Signature Date - 1 0/26/2014 3 .1 3.21 (1 030 075-100 (10/04) 000690 . . Ministry of Community Safety I Segregation Decision/Review Ontario. 8: Correctional Services Institution Hamilton Wentworth detention Centre Name (Last. First, Middle) - Client Identi?cation No. Reason(s) for Segregation I - Date of Segregation Protective Custody Institution Security El Medical El Inmate Request 09,14,2014 inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Signet of Uperintende ignate Date Tom Bradley 09/14/2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) inmate Submission Inmate wishes to move to a GP unit at HWDC. Superintendent Decision El Release from Segregation IE Continue Seg?gation Reasons: Inmate has a history of disruptive behaviour at HWDC. Inmate has prior PC status. . Name of Superintendent/Designate (Print) Signature of superintendent/Designate Date Tom Bradley 9 . 10/14/2014 Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate'Submission . Superintendent Decision Release from Segregation Continue Segregation Reasons: - Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Supplementary Report for each SubseqUent 30 Day Period (use reverse of form for'additionai comments) - Comments Superintendent/Designate Signature Date . 5.1 521(1) 030 075-100 (10/04) . - 000691 air2:I-liI II Ministry otqemmuqittsafll' Segregation :5 Correctional Services. ,IIsi .111*": 13.9 . '1 Institution -- ,iI":Hamilton Wentworth detenltiOn Centre ?N?me?ast. Fir'lSIthiddieI) I .1 Client Identification No. 2,3 I iji- . - -I - I t-I. I i 'l 'ii? if "at! it "tng DateofSegrega'tion 7 3 - 151:1. . . -I 15-! Protective'thody?fr' I3 Institution Security dical :?lnm?ate Reguest i 10/16/2014 L- 31.: list .Inmate advrsed of opportunity to written 3 lift?' . - 5 {in Inmatel'adv'is'ed of reason for segregation Inmate'advised of opportuntly for Interwew Superl Name of Superintenctqe'ritipesignate (Print) i 4-. i' if!? . . .l . . ntenden inmate waives opportunity for Interwer Superintendent I II . .- - '3 Signet re of superintend - te :1 Date 7: . i - a -..II . . - 10/17/2014days of the?mmate's placement in segregation) . JtIl'sIItgittuIs' . I - Tam Bradle L-i. - 53'" 7 SU erlntenfdentt?eclsnon (This section must be completed =lnImIate Su_bI Niki? -. peerissuesin GP andrefu l? - . Superintendent De c'ision Release from Segreg?atiohi'ii' 55 IZI Continue Se?egation Reasons: F: quI-l-ItrI i At Inmates; . H, .l'lg?i! - ?at I Lil. 1"{Name of superintendentiqeslgnate (Print) r. Signature of Superintendent/Designate j; . Date if. 5 T'ar'n . med/20149" j_ Segregation-Revrew (Inmate's segregation to be reviewed every-5.days. Interview with inmate to be conducted every 30 days) I Inmate Submission I I - I 4533inmate has numerous peer issues in GP and refuses-qutatus - Superintendent Decision Release from'Segregati IE . Continue Sgreg?ation :IitI inmates-request r9311}; l' Jig-1'! . II Name oIf,SuperiptendIentiDesignate (Print) {If I Signature of Superintendent/Designate Date TomBradle'yu'a -- 3:5; -- i- it?: 5 11/17/2014 - Supplementary Report for each Subsequent 30 Day Period (use reverse ofionn for additional comments) g9, -- - Comments . i i gIrIjI; Superintendent/Designate Signature I1 Date I 1' I 1 himseems-100116104{.ri . - 000692.. f??nity "'T'DecisioaneViGM serviees - 6h Centre we ?rst. Middle) ?iilsi Ina-Iv.- .: q: forfsegregatilonx?): mi! Prote?ctlve;QUStody . Institution Securi Date of Segregation 1 0/25/201 4 Medical - Ii'fieel?on-for segregation :1 Eannate adwsed'of opportunity, to make oralor written . Mu? .. .. I . .g-w I. A 1 u! I .Ilfl.l I. ?Li Raf-T": . I I "ed of opportuntIyI.-for Interwew w: El'fnmate waives opportunity for Interwew Superintendent Date . nu yell} ?y ?1 -. i-[Vi I I E. n, his se?tion j?completed 10/27/2014 Q?nd requ 5.1 j? t?Decision" . Signaturi?ege'flSup Date 10/31/2014? I . I evuew (Inmate's segregation ed evemsldays. to be cond :71; a? and refuses: Continue'Segregatmn -??isnate (Print) . Date 1 1/26/2014 A: "ll Mil." H.212 each SubseHU od- (use reverse of form for additional cor'n 30 Day Pefi tangent/Designate Sigdaturg i {ii-1.1. Date 5' i I i 000693 5,81 correction 1 gnu-.1. . 1"711 .. nu; mtlton Wentworth Edetentton Centre - . - x. . jug?.7No.4,- .251? Date of Segregation . 10/29/2014 A ..-. @i'lrt'stitution In?? - I :11; 'lnmate any/1 . 1: ?Ftotrsegregatlon . . 1? . . ?1 ,?is ,i'nmate advised of op IZ?tnm'ate Mil/{teed 'of opportunityth rna'ke oral or written submissions - Interwew? Elinmate'watves opportunlty for interVIew Supenntendent ?ii'ilt'?m'eof 1,11 11;; II '3 "53" ?lm-i. 10/31/2014 '7 11513315111313 1.1 1511.111" 1111151211 a_ .- endent DectStIIani 6T his section ment in segregation) . . e'r'lt DeciSion?l 1, . Continue Segregation -. 1 tong pooereh?a NIecafSupen'n tendent/Designate :3 NH .: ,1 I, nigh-1 Braai? 11/03/2014 I eviewed even/'5 - .. .21: l5. . v. tiSegregationg?eviewf 51- "with"! 1? - ?s segregation, dails. Interview with inm ducted every 30 days) - Submission .90. ??335 - - 6W1 Segregationjgsir ue Segregation tne-_of8uoegrintendentlr13: - Signature oi eradt?y- 1 1/28/2014 ?'ach SUbse 111130 Day of form for additional comments) '5 3?1? Supplement i 5.14121611131 5.211112, I .h I .,11 -. i it; 000694 . r? - .111111- . opuinunitys Segr .. .Mini??tli'v .. z. ICOijrectie'?lfa'nl rsrrervice9.1 Institution. 5:1 - .311 I -, - Itn?r'f'l - :.iI1-11 I . I v.1; -. Hamllton Centre Middlexi lilij - ?Cllent Identification 7.12If. asoms) tor Segregation; - fl"- .1 "a in?ate 01{Segregation Elsi; Olga/2014 I 115-2? Hi?. ff, I -. Security- -- g' gatefadvlsed of reaI E?r?egregatgon 1-. - ate 'a'cNised of I ?g??i?interview'wit f; I 3 1 _2tl3radley. . IT I 3: .. .SLbBI?lntendent DemsIloI. .- section mast aqcbm'pieted within 5; aye: 'of the inmate Inmatemequest . :i'11.24. Inmate advused of Opponuntty?to make oral or mmen iffj'? {F?lf 1' - --: Intendentf?a' .. Inmate waives opportunityiomnterview with Supenntendent - 3 "$jgnatpr_e OfSUperinten I jgnate Date I {11.t?rSubrhiSSOn' -. . he Segregatlelnrl 221?. 11.?If. 1:12:53: - :Ir . [Iaipoor offe?de s;aire afraid of offended 'i.lji I IV exp}; E'r'iiu?: - I . "ll? 7' - J. I 11152:. I 3M . :1 I '11.:I'llhl'l i erirjtendent/IDI . 111-. 13? I. 4 T-?ja Fb?i?f?radley' Date I .3 wily?. "311/0'3/2014 IIctedeverysbaajI/{351213 '1 - - :?Ir'lifu - . Iggy to be'qreyiewed every withmmate to be on '??-?uhh1i??i9n f? - - . . ?iymt 111.211: I I Iri. .1 413 Seggqatio'mji? . a '5 311.3. . Hr? w'li . . - .. 1:15:11}. . i ?gig .1. l' I: - - .'i'fmi I I. ??13001 5? y. Iggterint"1-11.12. u??eljintenden ..II It?: I E. 31? of Superintendent/Deg"; Date?: tisa?.? I - 'ill?II - I I riff-Bradley . . I I 1 .31 . 11/28/2014 II . . ?1 -s 5195-? 3L - 1:5? 151:! pplementary r,-77Iach Subsequent 30 Day Period (use reverse of form ,ments) . I 1' j, I :?I??g?j??bmment? 9113?; 3_ I SuperintendentIfDesigna? HISignature :..-Date I $111.12: ":13 121:5 l" ?3 aj?:.:21: I 35"" - 1 5141231101)!- 521(1) 91191111 I. '1 . I 12.11.". 1' =1 ?3 I . _at .: Hr '?it . . It ,ti. - '3??it? Institution - .. it it; I 'l 1?er l?iti?_ I i 1' t' 15:? I: . it": - .. Hamilton Wentworth detention Centre "'eillfa's'titfriret, Client identi?cation No. I fruit?" tit7513:: ..J13i I l- I I um}, v?if" mitt-1:. . .t ?Date ofSegregation I.t-t Sixty. tr; 'twg. f? a? in?? *wi' igt ?In tutIon SecurIty Medical E'lnmate Request - A - ?Igi ?10/10/2014 i. . itshim" at ,Hgtyiged of reaeg?rly?fjcirteegregatIon '1 inmate [adVIsed of opportunity to make oral (tr-when SmeISSlonS if: 'tiiwt3$t'ty.t' I - ln?rr'Ia eyciviged of oppg??npjinyOr interview With?Su ?eQrintendent'I. i . 1, El Inmate Waives opportunity for interview with S?perlntendent . :33: Intendentl/Deflignate? (Print) I: - Signature of Superintend nate I., Date i .I _l :1 i 1.ti; 9121131127157 . 1 I $151 - . Uni! :j Sl?p??lnten ent his section must be completed within days of the inmate's placement in seg'r_egation) 5? i tinitti-?I' .- . . i t. 'in'the at HWDC - - 'it'f?r It Ming: 't - A I'.l ifContinue Segregatioh"?" Ill-7": it - I 1' . Ii? in}! I nit! amt - 411151its-i: 8? I i 10/16/2014 Ft . l . -- tans-?i . - .. :se' 't I'Eg'afln ,z??ewew nm?tei's'segregation to be reviewed every'st-days. Interview to be conducted every 30 deli/s) . gin-t - - t; ?Effig' - peer?s?issues in the PC12 units at HWDC, . I, ?nth-in:i'f'tt i- gtl?151? I . 54,Ijt - .i-liIii- 'tlti-tji its": .r .. j: ReleaSe?.trom Seg?gationi?ii .IZI Continue Segregationie"i3 li't?i'? - 'fl-II35;; - :73 gala Emil] lg?? A 3* ?Ii' tli'titi .try-eig?iittitigendett? .: - at . .ati i Eight: .- .. a I tiger HittititittReportioreach Subsequent 30 Day Period (use reverse of form for addItIonaI comments) tifiliit' igornments i,-j 15" It Hi? J-?i?t Superintendent/Designate Signature . i v.11?. t: -I ate, (Print) I ii. i {i Date 11/10/2014 Date . 111%?. A: . . Hi: ..- it. tut-TIT?" 1, .7. i I ,?ihi I 1" It'll. i ?tnl?J_i7?'f tit-21'I2IIi) 000696 . ., ?if! I . . . I ail:Iji' II I . Ii?; Min-strict .Cgmmumtiisafety; Segregation Decrsnon/Review :iItya Correctional SerVIces . -. I - 17'. "itElii'i' ff-Ji?Till'?St?m?m 1 - It - ii," ., - Tart-IfHamilton Wentworth detention Centre Name (Lastrl?ir'st. Middle) I. . 5. . - Client Identification No. - 17 I- ,IiIii? . f1?5"?tineesstnisiteressregauon - - Date of Segregation 1-. 5. 25" 11:1? Protective Onstody Ins, Medical? 10/1 5/2014.IIInmate advised of reason fqr?tj?gregation 5.: I: - I {1 '3 Inmate advrsed of opportunin to make oral or written Inmate adVis'ed {of interview.With.'Superintendent ., II . 1. Braldl?v'? . tons/20145.1 If -I. II I: _ifgih Superintendent [its section must be completediwithin 5 days of the inmate's placement in segregation) Request is. I?JtInn Security xii Inmate waives opportunity; for interview withrSuperintendent ri-I Signature of Superintendenp?DesigInatIe Date I . 4.x l'l -r Submission-:33 Ijamull . . _J?mate has-Iriumerous peehiisIsues at HWDC 5?3- lyizi?rHSUPerihtehdehI'DeciSion Release from Segreg ation Continue Segregation I 335355905: sit. affii Jun-I. I. I {Ia-jI Signature of Superintendent/Designate Date 3' . . 1' :j i: {Iii-110/21/2014rName ofsupeIrintendentiDesignate (Print) 11!: 5:11-va git-Hz; i "i 5' . Eat?;- - 3:153}? 1-). . Segregation TFieVIew (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 daysmate requestsItoIrernaIirItiIlIn segregation sue to peer Issuesit"ll'g I I :f'fIL?ib' I - ii I '1 Superintendent Decision I . Release from Seggq?ation LI Continue Segr_egation .?x?e?son?t - - 5:5 "-3151; I .v '3 F: inmates rIejq?uest" . I - I. I ri-I . TI, I tliglp ., itI-I 'rIrintendent/Design ta. (Print) v- - I Signature rintendent/D Date .-: Witt-?1' -. 7i?if. . :?lti?qgtIf.? Brad eyI i'r-3191".? I ?i - Ilthh??I nit; I I I t. I Report for ach Subsequent 30 DayiPenod (use reverse ofrorm foradditionai comments) . Ii I. . 'gq?l'nments 1553:, "liq! a I '3.Superintendent/Designate Signature Date 35'13Isa3,5191 5'21{5:16. I 00069?? . iISegregati melon/Review I 8: Cor7?91i9? :1 Iii] . .1: . I ?eason(s) fqr?segregati .. f. - I I Protective @u'stody Institution Security I I Hamilton?WenMorth detI IriItioIn Centre Client Identification No. 1 ?3 i. Ii} 3.51 . :17! 11;. 5: i Date of Segregation 10/12/2014 Einmate ac'i? ireason?ior segregation . 11"; 5! - - 1 Inmate ainI??HLOf o?pportuntiy for interview with'Superin in?rnateIIHIeIciue . 1 Inmate'advised of opportunity to make: Iorator written submissions . I 1. Inmate wait/es opportunity for intervievi'with Superintendent 0f ?girintendent/DeSII _rSignature of Superinte'ndent/Designate Date I 1 _1 11- 23313;: . a 1 his section must be' comp! avIeI numerous peerI issues 'at 1 151? Lil-l1} I 1 Mn; 51-11. . (it? 1?16; . Im? 11?" 1 ?1 hit-?11 JUI- 1- I IP15. El?; my. 441 Atinmates'reguest I 1II .._Superinte 'I?ht Decision: I IT?oIrn Braciieyg Iii, of Superintendent/Designate (Print) Date . 10/16/2014 3W 1 - I .19. . I g-Segregatlonl?iewew (Inmate?s segregationiobe rewew :1iilrl1rnateSubn1is?l'ifon :1 i . I 3- ate claims-to hay'e numer0us peer iss 1 . 1a., . 11.II.- I II .. - every 5 days: Inten/iew with inmate to be conducted every 30 daysSIUperinten' .13.: iI??asons: I ?tjiinmatesnje - ..-1 - "'1'11 115C11a?esi' Release'from Se' 1 Segregation I II . iTom Bradleyii i_ up'erintle ndent/D I 1n . I Date . 11/12/2014' i erIsIe of farm for additional comment's}i each Subsegu ~13: 1?11 1y.1Perlod. (use rev 1 -- 1 - gupenntendent/Designate Signature Date I I 000600I renal ~?IiServiICqs - 321141.54; 110. . jlib?t??f? Sqdf'esatienf'a I .i . "-11 . 09/14/2014 111111195 Days i'n'Segregation .4414 I 60 days ?2014 (If. .NO Why" "i '3 Peer c0151?- g?lf'Ndey fpe?piss'u?s ?111-; 411"}: 1' 1551111: {Ex'r?ht mg?j?iUr?ut 3N0 serious health s?crgl Worker . I 2' "Been regularly by worker 1 C?b?s?j??qi item VI .Ir CPI . 1: 4 trlyi; ?fir??iliv oio'gg' ?Ch'o'd's?'ah'itemQ- .: i 5'r11?) 5 Pradl?y 521(1) 5.211 u. .I ll! --I 1 i} find ., .h for. ti-Worker?? Egan?g?g? a_n angitemfi-y Tl d?'?ian' Iitemi,? *0 R??Hephjseu From t?g'ai'?d I - I Il?rl .l?l . {:hl 31?: intenden thIeisilg?n'ak? Sign'atilr 'Sept 24 2014 s?dt?sation NOV 25 2014 Ure 6f going ?sychological and phy?i?al Ewes Ii-iri a . i . Seegriaglrlegullgirly by thgkar?omal worker area Sergeant . . 'Ssafety andcongectlo?ga II: ICli?nt [de?iificat pate of I'Seggregat'l?frj?j '7 07/10/2014 Seg??bation 120 gays Dater?gvieWed NoyZ27fl2014 [11,13! 15?19!" - ?90 cunty. 5' 5 -: -. ,ItemC:?5?si? an item: In A cob? . -. .Il..-.-.-- "In +1 involved 915;" {an that.? .. . In"- If ?0 WhVi air-?rmlyajJ?Extent of ?lnv'olijemen an :i I . I I No;serlous health -I ?lls. a' n. 20'! 0: ?SeIeh regul?Hy Iby work?_r iic?gq?efan iter?iiz, to R?ih '1 A vchfojosezan itemgag m. - j= aGlIan?e an item. . Ti? '2 '13Hme?rat?ifJ-.-. I: .291. L??hhFrom El IContinue Segr II I .I I: . . J-g?QrgIrit), $15,591 . VII I I - . - film sink-:5. - . -- tgndenun??ia?i?esighatme'l' Dati?f'i?ov 27 2014.IHI ?3?:.I.. . 4:52.00. . I I 521(5:9" 000701 I E?s? 3- 1am . I and Cdrf?cft'i gfe Ip? g: 7 Ov9n60,Pa3/Ts I. S?'gr'e?d?ltim FA I ILI I . . ?flj?lService' m?zi?ast, 1 125-33 I 'Dafe'Qf'Se?r?g'ati?hii?i' 0219312014 Total Qay?jin 4291.65.33? 1 5 LDate??ViQi?w'ed' Nq??jz?f??z?o14 ?I'm 'M?s mas-e ?er'Em4.4.43? -t 1?5524 t1, . a 0 4 5mm?? . I I. .- 433-7 LII I If No g?eason. ia ?l ?73 A I .Pee'f'isslues? I a, I gb?w?g :Choqsc?i I ., ll ?5 co?ej?g?lfCS?ttmg Chogse" If Peer'issues maul 'n I I -awhCare. f-gii.' fExt?n?t of Involvejimenm . I ?ll Nc'se?ous hgql?h earls;I ifsSues H?aith Cafe . . I I I 509i?" Workef-fr S?en the "I'??cial 4 ii I 95063.6?" 1:73:53 II 'l 1 iter? Ii} (- I I 3: -I- Chbb??jel'E'jsfe'lFrcim Il'mfIia'te Nam? (Prim)?- - . Sig-55mm. Davin?Nsivember . "5.1 7 i- i 22.; f; :9 1?st I 'a-"fi 5, list000702 1 irttat' it'd?gait .- '1 ?53" "Eta-1., til-1' 1th.}; ?137,335: 'afetyjand Correctional L34 7:1 . .. I rig-q: 251:". - Hie Elli-Hy ?in?llIn?: Days ll.v. s'CIient Date or s?htes?iiti?.= .9541. ?3 ?i 2' -- . 213:: axeggmn i111 . 1? I . - Total Days in s?g?r?gg'ation 540? Date Revi??ted: i1 - phgose .an Item -. I Signatur?lsf Destbn?te 1- .v Chlo'psie ??3itsm._ . .4 t. t?ggteh .?ftgj?arw "f?m . . . L-Eagln'y?to I If No m? {Peer Issues . wt; at? - Iii-Setting ..I Jr?! I I i' . .is'l?ltnvolvsd . Kbiiltty'to coti'?' .?E'Peer issues . _,'Extent of z'i?f 't .1, - - . ?am: '5 .. H?al?fh Care 6" health relatsd Issues '1 .ijji? . . 8991s] WorkeIZI-rg?t 351.5?; . wag-ts revnewed - 055.6% an item?ff-?tl! :Ii'i?tuf?i'. kit-?tt??t??t?a'nmatapb'mt .Qnoszge t. - r'i" . - 1. . 03:1"? I Eras]; L52 firmiets'rF In I tt?t filly l?t'f' .P'vr 7 FilmName (Pri I I 1 thJ' . 14:? I . . aura . 'Dat?i?guzmou If! \ll 006703' it Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar .Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into tl 30 continuous days in segregation Inmate is admitted to segregation on September 5th will be capture E?K'Tr??sf? 3:0. 37??6 . 9 . E?s) Left-I?: 3:3:?1 r?"Region i a GalendareMonth Fla-Year- "c tr "21-., :34" a nu. A. 2,17, 1: slur I5. . - r- .12, sewn?re} mks-Vise 2-. a If?; aw ?2 ,5 a i=1; gt ta; .eg'aa-(Lasttoml?? . 4-. -.-. -- 1H'rl-vlJl. ?at: lam WN. SWDC Sep-28-14 swoc Aug-1944 S.NIR 000704 month. he next reporting month once they have reached the ed in the October report if more than 30 continuoUs? daysE?"?s'8350" OF 89 regatlon as. 11.Inmate is in need of protection Inmate is in need of protection 000705 ?:IssueS) - .. r: . - '11an?. A m. .- .934missed); my. e,?v ntinlan a as can not get along with other inmates This inmate has mental health issues Yes can not get along with other inmates This inmate has mental health issues Yes 000706 Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into tl 30 continuous days in segregation Inmate is admitted to segregation on September 5th will be captun - :L2.- 3855?;Reglon'a'cr - 5 in. 2-5} 5:32 7.ONLYr-Jnformatwn war; .: ll . --.-. .. ace 1n? 3.1, 137 segregation . .. -, .. ?I?tofforw??rdihgi?tcmom45)" ., I, s.21(1) 1.. 7- . rum-L re A . rt,r,oz. swoc Sep-28-14 swoc . Aug-19-14 000707 month. he next reporting month once they have reached the ed in the October report if mOre than 30 continuous days). Inmate'is in need of protection Inmate is in need of protection . 000708 sp?pi?trR?asms arid :D??tail?s; Dde's: 'thi?ii'?niai?ihav?va "I-fdr' i needscan not get along with other inmates This inmate has mental health issues Yes can not get along with other inmates This inmate has mental health issues Yes 000709 Regional 30 Day. Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into 30 continuous days in -. a. u. 7-?1 .25 ?an 26.1.4. segregation (e.gL, Inmate is admitted to segregation on September 5th will be captun 521(1) to?foMarding to 5: - First, 113??. . .54 . 7., A 2 -. his?it (?511; . . 000710 month. he next reporting month once they have reached the ad in the October report if more than 30 continuous days).. Inmate is in need of protection Inmate is in need' of protection 00071 1 . org-*vu mus: ., Issues - - - I . . .t . '957 -can not get along with other inmates This inmate has mental health issues YES can not get along with other inmates This inmate has mental health, issues Yes 000712 5'3 . Segregation Decision/Review Ontario . Institution Algoma Treatment and Remand Centre Name (Last. First. Middle) Client Identi?cation No. Reason(s) for Segregation . Date of Segregation 1/10/2014 Protective Custody Institution Security Medical Inmate Raouest inmate advised of reason for segregation inmate advised of opportunity to make oral or written Submissions Inmate advised of opportUntiy for interview with Superintendent [j Inmate waives Opportunity for interview with Superintendent Name of Superintendent/Designate (Print) . Signature of Superintendent/Designate Date A. Golder Superintendent Decision (This section must be completed within 5 days of the inmate ?s p/aoemen/ in segregation) inmate Submi55ion Superintendent Decision El Release (from Segregation El Continue Segregation Reasons: offender continues in medical segregation due to physical and mental health lssues.recent periods of suicidal watches. Under Care of November 15,2014 no change to status. Mex/19,2014 offender is on a suicide watch and will remain in segregation. November 24. 2014 remains on suicide watch. November 29, 2014 Ongoing physical and mental health issues. Name of Superintendent/Designate (Print) - Sign/ante uperintendent/Designate Date M.Piraino 11/29/2014 . . Segregation Raview (inmate's segregation to be reviewed every 5 days. int be conducted every 30 daysg . inmate Submission . 4" Does not wish to move at this time. . ISuperintendent'Decision Release from. El Continue Segregation Reasons: I . Offender is still in care from a and at this time is not suitable for a range and the Doctor wishes him to stay where he is. Name of Superintendent/Designate (Print) . I Signatur of Fintendent/Designate Date A wet-IE. . Jig-4210512014 Supplementary Report for each Subsequent 30 Day Period (use Comments Ruperintendent/Designate Signature Date MM/dd/yy'yy No change to Mental Health issues. . t. 4 Dec 17/2014 CSD 075-100 (10104) DEC 1 201?! it 514(2)(it) s.21(1) s.21i2)if) 000713 Page ?2 Regional Director Review Continued Segregation ?ppo?ed Not Supported Comments CEA 4404 kt?l 1:62-14 - x'J'fc/C 1 (ILA A [Moe vi Calm?'1. r' 15 f3] 1 rife? NammDirector/Designate (Print) Signature of Date act/$7 3 Q?h? .M Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments i Comments Signature Date i i [VIM/cime Continued/Additional Comments by Superintendent/Designate Camments Signature Date Continuededditional Regional Director/Designate Comments Signature Date Dlaulbnuon; original Roglmil Director (Only for Regional Director Review) copy - inmate Filo CSD 075-100 (1OIO4) ., i 3- "7 00071 4 Ontario Name (Last. First, Middle) Segregation Decision/Review- Institution ?goma Treatment and Remand Centre Client identi?cation No. Reason(s) tor'Segregation IE Protective Custody institution Security Medical inmate Request Inmate advised of reason for segregation Date of Segregation 0711012014 inmate advised of opportunity to make oral or written submissions inmate advised of opportu?ntiy for Interview with Superintendent inmatewaives?op?ortynity for interview with Superintendent Name of SuperintendentiDeslgnate (Print) Signature of entl i at Date A.Goider - 06/26/2014 - Superintendent Decision (This section must be completed within 5 days of the inmate 's placement in segregation) inmate submission - - Admin seg I Superintendent Decision El Release from Segregation - Continue-Segregation Reasons: . - Mental Health I Special Needs Name of superintendenUDesignate (Print) Signature of SuperintendentIDesignate . Date Kyle Notte Security Manager 7 07-15-2014. Seg? reg'ation Review (inmate's segregation to be reviewed every 5 days. inten?ewwiih inmate to be conducted every 30 days) inhi?ie'S?ib?il??lti? I - - Stated his lawyer wants him to stay in segregation Superintendent Decision Release rrom segregation El Continue Segregation Seasons: I Mental Health I Special Needs Name of SuperintendentlDeslgnate (Print) Signature of SuperintendenUDesignate Date Kyle Notte Security Manager . - . . 10?09'2014 Supplementary Report for each Subsequent 30 Day Period (use reverse arronn ror additionarcommanrs} - Comments SuperintendentlDeslgnate Signature Date - Mental Health. To remain on administrative seg. Demo/2014 - . 5) Mental Health. To remain on Admin Seg - 1 1? 712014 . s.21(1) DEC 0 3 030 075-100 (16104) 000715 Regional Director Review Page 2 Continued Segregation 5E Supported Not Supported Comments - . MU Nekuk/S/aew? new} Name of Regional DirectorIDesignate (Print) yr Si ional DirectorlDesignate I - - Date Supplementary Report for each Subsequent 30?Day Period (use bottom of form for additional comments neg/i Comments . Signature Date? I 1 . . Mental Health. Admin 899 10/09/2014 Mental Health. ?Admin Seg? 1111712014 Continued/Additional Comments by Superintendent/Designate Comments - Signature Date . . . . - unable to interact with othe'r-offende and wis?heS' to 'remain' 1111712014 in segregation mag; 2i 7 I Continued/Additional Comments by Regional Director/Designate - Comments - Signature Date Original - Regional Director {Only forRegionei medor Review) Copy - Inmate File CSD 075-1 00 (1 OI04) 000716 ,t Ontario I Community Safety and . . re ation Decision/Review Correctional Services 369 .- Institution Aigoma Treatment and Remand Centre Name (Last, First, Middle) Client identi?cation No. Reasonis) Segregation Date of Segregation El PfOieCIive Custody Institution Security Medical Inmate Request 0699/2014 Inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions Inmate advised of?opportuntiy for interview with Superintendent Inmate waives opportunity forinterview with Superintendent ?Name of Superintendent/Designate (Print) A. Golder Signature of Superinte tiDesi ate' Date 06?17-2014 iv Superintendent Decision This section must be completed within 5 days of the inniaIES/placement in segregation) Inmatesubtnisstan Stated he does not want to move out of segregation Superintendent Decision Release from Segregation . . 7 ?Continue Segregation - Reasons: Offender refuses to go to unit. Stated he may have issues and does not want to get in trouble. Kyle Notte Name of SuperintendenUDesignate (Print) .. - Signature of ?e an 519 Is Date 07120r2014 . . . Segregation Review (inmate?s segregation to be reviewed every 5 days. Interview inmate to be conducted every 30 days) inmate Submission Admin Seg. Does not want to go to unit. 'S_'uperintendentDecieion CI Release from Segregation Continue Segregation Reasons: 7 Will not go to range Name of SuperintendenUDesignate (Print) Kyle Notte SecurityManager Signature of ?er' an '9 la Date 10-09-2014 Supplementary Report for each Subsequent 30 Day Period (use reverse My Comments Date A . Offender stated he wants to remain in segregation. He feeis that he cannot get into trouble in seg. 08l12l2014 2 ., Remains admin seg 09/1012014 0 3 201 \W\w (330 075-100 (10104) 000717 Page 2 Regional Director Review Continued Segregation Supported Not Supported Comments Name of Regionai DirectoriDesignate (Print) Signature of Regional DirectorIDestgnate Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Remains admin seg at his own request 1010912014 Continued/Additional Comments by Superintendent/Designate Comments I Signature Date .7 . 7 ?ea awry/2524512541? ?aming? /%2yd '?jfwj . artContinued/Additional Comments by Regional DireotorIDesignat Comments Signature Date Distribution: Original - Regional Director {Only for Regional Erector Review) Copy - inmate File CSD 075-100 (10104) 000718 {*POntario Segregation DecisioaneVIew Institution THUNDER BAY JAIL Name (Last. First. Middle) Client Identi?cationNo. Reason(s) for Segregation Protective Custody E) Institution Security Medical inmate Request Date of Segregation 1 0/22/2014 IE Inmate advised of reason for segregation inmate advised of opportuntiy for interview with Superintendent Inmate advised of opportunity to make oral or written submissions I Inmate waives opportunity for interview with Superintendent Name of SuperintendenU'Designate (Pn'nt) Kevin Holmquist Signature of SuperintendenUDesignate Date - 10/22/2014 Superintendent Decision This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission NS Superintendent Decision CI Release from Segregation Reasons: AIS SECURITY: Continue Segregation Name of Superintendent/Designate (Pn'nt) Happonen Deputy Signature of SuperintendentIDesignate Date 10/27/2014 Segregation Review (inmate?s segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Debision' Release from Segregation Reasons: I a CO I Continue Segregation Name of Superi te denthesignate (Print) Si a reo uperinte tiDesignate Date Mom ANSupplementary Report for?each Subsequent 30 Day Period (use reverse often?! for additionaioomments) Comments - SuperintendentiDesignate' Signature Date - Stacy/LL WW ?ee/?it, 7 Mia/24%? s.21(1) DOTS-100 0l04 C5 (1 Novzl 2011. WM I 000719 Page 2 Regional Director Review Continued Segregation Supported Not Supported //cac en} ti C, bro-d A my? APC'cr/r? rJ/u Cr ional DirectorfDesignate (Print) Signatgrg; 'gmate Date I .n a Captor (L. (I ?zf, 7: Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature . Date - Continued/Additional Comments by Superintendent/Designate Comments - Signature Date . Continued/Additional Comments by Regional Director/Designate . . Comments - Signature Date Distribution: Original - Regional D'nctar (Only for Regions! Director Rew'mv) Copy - Imam File 030 075-100 (10I04) 000720 and Correctional Services . Ministry of Community Safety Segregation Decision/Review Ontario - institution . Thunder Bay Jaii Name (Last. First, Middle) . Client Identi?cation No. Reason(s) for Segregation - Date of Segregation Pfoieciive Custody institution Security El Medical [3 Inmate Request - 0921,2014 '"ma?e 0? reason. for segregation - Inmate advised of opportunity to make oral or written submissions Inmate advised of opponuntiy for interview with Superintendent inmate opportunity for interview with Superintendent Name of Superintendenlloesignate (Print) Signature of Superintenda ntlDesignate 3 Date DYRLAND . . 09?23-2014 7 Superintendent Decision {This section must be compieled within 5 days of the-inmate's placement in segregation) inmate Submission NS MISC . - . -. r1 . Superintendent Deasron Release from Segregation Continue Segregation - - A Name of Superintenientioesignate (Print) Signature of Supe?nienmle Dale I Wt u;me . - m4 . . Seer 27/13; .. I . _7 My? Segregation Revrew {inmate's segregation to be reviewed every 5 days. interviewzviIh inmate to be conducted every 30 days} a, Inmate Submiseion Superintendent Deersmn Release from Seqregation' Continue Segregation Reasons/Mrwm~r war Name of Superintende gnate (Print) Sipnature of 7 rintendentIDesignate 3 Date .. mm) [a aaTAI/zr/ I . - a 1 Supplementary Report for each Subsequent 30 Day Period (use reverse for rumaroommenrg) Comments Superinle ndentloesignata Signature Date . A . )Cb?oF/Ue?? Wwfw?su?a . ?ewaauw? Irv 5'53 M545. 5?33? 15/9 pm .44 45,24 we; a of ?t 2 4.5g g} 39/4 r/nuc I: a? 5 - Wf$ we?: LWVAVE Wu?? I It lu/r-? Prom-Wu - - . 0 csoomoomm 5-21?) NOV 21,201? - mi fveLMJ/wr/U?M 6y? i r? 000721 I Regional Director Review Page 2 Continued Segregation Supported Comments 51W and? Anew J. [3 Not Supported ,r rim new egional DirectorfDesignate (Print) 151.4: Name gears?W Date bottom 6f form for additional comments Supplementary Repbrt for Comments each Subsequent 30 Day Period {use Signalure .- Dale 24;] do [Lil/1?5" A) ?nite/u] I . 070 rig/V I - ?w -7 ContinuedlAdaitional Comments by SuperintendentlDesignate Comments Signature Date - a 14(2)(d) s.21(1) ContinuedIAdditional Comments by Regional Director/De?nate Comment; Signature Date Distribution: Original - Roglmal Diredor {moreregianu under?owa Copy - inmate File 030 0795100 (10/04) 000722 . Segregation Decision/Review Zr Ontario Institution Algoma Treatment and Remand Centre Name (Last. First. Middle) Client identi?cation No. Reason(s) for Segregation Dale of Segregation . 6/03/2014 8 Protective Custody institution Security Medical [3 Inmate Request 0 lnmate advised of reason for segregation I Inmate advised of opportunity to make oral or written submissions Inmate advised of Opportunliy for interview with Superintendent inmate waives opportunity for interview with Superintendent I Name of Superintendent/Designate (Print) Signature of Super' te dentJDe ignate Date A.Goider . I . Ag ,1 06/22/2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission Superintendent Decision Release from Segregation Continue Segregaiion Reasons: Mental Health issues. Name oi SuperintendenUDesignale (Print) 7 Signature of de De nate Date Kyle Notte Security Manager 07?20'2014 - Segregation Review (inmate's segregation to be reviewed every 5 days. interview ??nmate to be conducted every 30 days) Inmate Submission Offender stated he is willing to go to a unit. Remand Sergeant looking into compatability issues and clearance from Healthcare SuperintendentDecision. [3 Release from Segregation i2 Continue Segregation Reasons: Mental Health A . a Name of SuperintendenUDesignate (Print) Signature/oreWm Date Kyle Notte Security Manager 10-09-2014 Sup?ementary Report for each Subseqbent 30 Day Period (use reverse rm tor additionalcommenis} . Comments 81(p?rintendenUDesigna Signature Dale I Offender has been recently moved back to segregation. He was housed on a lock down unit but began displaying 08/120014 bizarre behaviour. he began yelling and swearing at staff :1an Q?l?andin? nn 1m? Admin Seg. Mental health 09/10/2014 521(1) 080 075-100 (10/04) 000723 Page 2 Regional Director Review Continued Segregation Not Supported Supported Comments g9ij 6'4 I.) fay/gig?? I Name ot? ionat DirectortDesignate (Print) Signature of Re jg,? Date ?(mp/Kc Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - Comments Signature Date 1 . MMIddImy Admin seg. Mental health 10/09/2014 Continued/Additional Comments by Superintendent/Designate - Comments Signature Date Continued/Additional Comments by Regional DirectortDesignate Comments Signature Date Distribution: Original - Regional Director (Only tarReglonatDirector Review) Copy - inmate File. 030 075-100 (10/04) 000724 gmmun'wlssafetii? and Segregation Decision/Review Fr. t'ona as Institution Algoma Treatment and Remand Centre Name (Last. Irst, Middle) Client Identi?catIOn No. Reason(s) torSegregatior?i? Date of Segregation . . 5/9/2014 Protective Custody Institution Security Medical inmate Request Inmate advised ot reasonior segregation I Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for Interview with Superintendent Inmate waives opportunity for Interview with Superintendent Name of Superintendent/Designate (Print) Signature ofSup rI endey?esignate Dale A. Golder 14, 10?09-2014 Superintendent Decision This section must be completed within 5 days of th'e'rnmate's placement in segregation) Inmate Submission Superintendent Decision Release from Segregation Continue Segregation Reasons: I . - I, .. ""t'Ag . ne'fo (3027 Xz/L?wirl 397" ?Arr/9 i/P?Uc/c/trfz? . (2/51 ?/w?dlr Caf/ ,4 $11424de (247% 7 .- {Jul/4 Ma?a 0% (145152", 414/. Mada (ta/u Name of SuperintendenUDesignate (Print Signature of Superipj n, nate Date ?Y/rnn'wa 7c? 1. gr .41, K) 2' (2/005 Segregation Review (inmate's segregation to be reviewed every 5 days. 'Intervrew vw'th inmate to be conducted every 30 days) Inmate Submission - Offender stated he is not ready physically or mentally to go to unit and requested to remain in segregation Superintendent Decision Release frOm Segregation Continue Segregation Reasons: Physical and Mental Health issues A1 . Name of SuperintendenUDesignate (Print) SignaturW/?mate Date Kyle Notte Security Manager 10-09-2014 . Supplementary Report for each Subsequent 30 Day Period (use reverse/?rm for additional comments) - erintendenUDesignat Ignature Date Comments . 5.3% A Jim?- if Mental Health 08-15-2014 Mental Health 09 10 2-014 5.14tanI) 521(1) 050 075-100 (10104) -- 000725 Page 2 Regional Director Review Continued Segregation 11 Supported Not Supported Comments ?414 5? ?(JIt/e/ egional DirectorIDesignate (Print) Signature of Regional DirectortDeslgnale Date 444 04%, Supplementary Report for each Subsequent 30 Day Period (use bottom oWomments Comments Signature Date 7 Mental Health 10-09-2014 *5 i ContinuedIAdditionat Comments'by SuperintendenUDesignate Comments Signature Date Continued/Additional.Comments by Regional Director/Designat Comments - Signature Date n: Original - Regional Director (Only for Regional Director Review) Copy - inmate File 030 ore-100 (10104) 000726 s?eg'i?g?tidn DociSionIRoView ontario. -. i I Institution Centra'i North Coi'rectional Centi?e 'Name (Last. First. Middle) Client qunti'?ca?on No. Reasongs) for Segregation . Data of Prot?btiire Cu?tody Institution Security El Medical Inmate Request 10-07-2014 Inrnat_e aa?sed of reason for segregation Inmate advlsed of opportunity to naake' oral or wnu?n submissions lnn'i?t? advised of opportuntiy for inten?ew with Superintendent Inmat? want-loo opoortunity for Interview with Superintendent Name of Supenntendenmasignate - Swoe pg:an nUDVe?sjignat?g -. D?ato {1-24-2014 SGT. CURTIS DESROCHES . ?up?rinie?nd?nt D??cis'idn (This section must be completed Win 5 days of, tho inmate's placoinent in,segrog?tionRe'du'EsT SIGNED NOVEMBER '2014. - . . Suberint?ndent Decision Relea?se from S?greg?tlon . . Continue?S?graQatlon Regional . IV .7 R3 Pei RagwgiST. . - >loo?f_5up?e? - Flat? 5 to?b? r'evrew?d ev?'ryrs' d?ys'L r?t?rvi?ua Mm'mai?'re' Eo'ii? don?u?i?d Eir'?ry 363.5%) - -. - Superintendent Decision - Releasje from Segr?gation - - - - I - -. . L41.- SUp'ple?m?ntary Re?bOrt fof'each Subse?uent 3D 'DayPenod (u'se reveisa of form foi'addi?onalco?menm) . ?mm? .- . . - Dale" CSD 075-100 (10104) s.21(1) 000727 Regiona! bir??tdr Review Page 2 . Contihu?dSeg'rbgatioh suppoan zWa 575% Ch?? ad @372: Bf .I'n 5 53 N01 Supp?rled Ny?m?eamme?ig?a? (Pn?i) I a M- mui? k- ?Date Supplr?'rhent?ai'y Repor?i f0} ?ach?Subsequent 30 Day Peri?dd (u__se bottom of to rm for additibhal comments 734/! Signature Date - .l . Contin??diAddi'tidn?i Cor'nn??ri?b'y Su'perihit??nd?'nUDe'Isign?te Comme'nts - Date Signature .Coritin??dmdditidn?l Cdr?rimehtS?by'RegionaI DiF?ct-orlphe?signat?' ?dernments? f- I .y ?4 Signature ogte? . . .. - Regional amen} WhRegbnd mam; Copy - mm Fl?ra cso 075-100(10104) 000728 3 Segregation Deqrsranneview $Ohtario . CENTRAL NORTH CORRECTIONAL CENTRE Name (Last. First. Middle) Client Identi?cation No. Reasonts) for Segregation Data at Segregation Prot?ctive Custody Institution SecurihL El Medical inmate Request 10-09-14 lininate advised of reason for segregation inmate advised pf opportUnlty to make oral or written submissions Inmate advised of ob?onuny for intenriew with Superintendent inmate waives opportunity for interview with Superintendent Narne of?Sup?erlntendentiDesignate (Print) Signature of Su intend Designate pate scr. CURTIS 11-24-2014 perin'ten?dent Decision h'hrs section must be conipieted Mthin '5 days or the inmate's segregation) inmate Submission . OWN REQUEST. REQUEST SIGNED NOVEMBER 17?. 2014. Superintendent bedsion Rel-easefrom Segregation - Continue Segregation Reasons: - . (:53 95:1 Awash Raglluoggx? tln.? NameofSuberintendenUDeSignate (Print) re oiSu mew?, a. 7 Date . - Mod :Se regatron Revrew (Inmate?s segregation to be reviewed every 5days. interview inmate to be conducted every 30 days) Inmatesutimleeion - . - - _l17;. I 7? ?uperinte'ndent bedsion El Release from Segregation ?ContinLie Segregation reg-gar;- - rising or rPrint) Signature otISup'enntandentiDeelgnate bate v. i hr A- 'Su?b??dueri't '50 be; P??ri?o?d rug. stars??rbi'rh . Comments "r"l;late' - l- . r' - 050 075-100 (10104) DEC 0 2014 Q, 521(1) 000729 Page 2 1 1 Regional?blreclorR'ev'iew' Contin?u?d Segrggation (EL . Suhp'orled No! I ?mm ?ma, Aida/I c- ,1 - 4 ?Vi/h? I a ?meNayional Dl}ectoriljesignate (Print) Slg?aturg sf Eggional DiredorlDesifnate Date Supplem?ntary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments - Signatunf: Date Contin?edlAdditibnal Cor?m?nfs by SLipefinten'dentiDesignate - Comments - Signature Date - Cdn?n?e?lAddi?ohalCor?rhe?nt's by RegionalDirectorIDesigri?Comments Signaiure .Date"- - . - Flaname Drums! - ram Dxrauiar (Only Aw .Dlrudal Ramaw copy - mm. File 050 075-100 (10104) 000730 Segregation.DehisianReView Ontario . -. I - - . institution - . [Central North Correctional Centre I Name (Last,- First. Middle) A Client Identi?cation No. - Date of segregation 09-94-201 4 Reason(s) for Segregation Protective Custody institution Security a Medical Inmate Request Inmate advised of reason for ?egregation Inmate advised of ooportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent inmatewaives opportunity for interview with Superintendent Name of SuperintendentiDesignate (Print) - Signatur ofS intende Ignate? Dale SGT. cuRTls DESROCHES i 11-24-2014 Superintendent Decision (This section must be completed wimin 5 days of the inmate's hiecemenr in segregation) inmate Submission OWNE REQUEST. INMATE SIGNED REQUEST NOVEMBER 2014. Superintendent Decision El Release from Segregation El Contin?ue'Segregation 7 Reasons: - ?3 ?page: ?Aug meanLege - . - v: 1. -7 ?110Segregation Revrew (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) t. Supeiinteftdent Decision Release from Segregation Cl Commie Segregation :Nerne ef_Su?erintendentiEJ_e?_ignate (Print) Signature - spate supplementary Report foreachSubsequent 30 Day Period (use reverse affann for additionaioommentsQor'nments' a - t? superintendentibe?ighat? Signature I .7 a Date CSD 075-100 (10104) DEC 0 i 2014 - gm 521(1) 000731 Regiohal Director R?view Pag? 2 Cohtinu'ed Segregation KL Supported *Nm Supported if 5 10m 4 .76 mmak 04?41 7 era; 4 ,w?i 'J?ijj Wain" 74% i Name of pat Director/Designate Date? . mU/?k . . I . Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments I . Qomments Slgnature Date . MMIdemy Continu?edlAdditidpal Comments?hy Superintendent/Designate . . Comments Signatura? ,_Date . . Con?nuedIAdditionaI Comments by Regions Diretto?f/Desigrr?te 7 . - ?Comments 'Signature" I - . ?Mn/Irde plWon: magi-m - Rogbnd mews; (onummegrnworm mu) Copy inmate Filo' CSD 075-100 (10/04) 000732 Segregation Decisionere?vie?w g)0ntari0 Institution Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. Reas?on(s) for Segregation Date of Segregation Protective Custody CI Institution Security Mer?cal Inmate Request 09.264014 Inmate advised of reason for segregation Inmate aduised of opportunity to make oral or_wntten submissions Inmate advised of opportuntiy for Interview with Superintendent . Inmate walu'es opportunity for interview with Superintendent Name of Superintendent/Designate (Print) SGT. CURTIS Date . 11-24-2014 . 1 . Superintendent Decision (This Section must be oomgleted mom 5 days ofthe inm?te?s placement in segregation) lnrn_alje Submission - ownefReouE'eT. INMATESIGNED REQUEST NOVEMBER 17?, 2014SLmerintendent Decision El Release from Segregation Continue segregatlon Reasons I Re. thi?aW?-E?f. Name olSupe?ntendenUDeelonate (Print) ?n fsupenwden?be'?tgnate bate goo ZP/t?e I Seij (inmate'a?s?eoreg?a'tion to be reviewed every days Interview wi?r Inmate-Io be Iotindni?tteieti?ry SID o'est 7 i?me?sml?lQH - 1- a. Superintendent Decision Release from Segregation El Continue Segregation Reasjonel: Signature ofSuperintertoentIDeeignate - - pate Supplementary Report for each Subsequent 30 Day Penod (use reverse afforml?or additionaloommontsCommente Superintendentfoestgnate Signature .rpate?? - -v .- ran CSD 075-100 (10104) 521(1) 000733 Pagez Regional Directbr Review . Continued Segregag?gn Supported Not Supported - Comments - -: . .Cr (h?y ?4 ?nc (CAM I 6k.) ,4Lv( 749_ ?7 o? . nal Di orfDesignate (Print) Si Date ,1 c1? Nc'nqw/ag x; /r . _7 . Supplementaiy Report for each Subseggnt 30 Day Period (use bottom of form for additional comments Comments Signature Date I CdntinuedlAEldi?bn?l Coinr'ne'?ts by 'Sup?iintendentlDesiQnate - Comments Signaturp Date Continued/Additional Cdrr'lm?nls by Regional Dire?torlD?'signate" . - Comments . - Slgnaturp Date Distribulicn: Origin] - Regiond DimcIu-ar (01w Regional My - Emma Fla CSD 075-100 (10/04) 000734 Segregation DeCision?iReview. institution Central North Correctional Centre Name (Last, First. Middle) Client identi?utlon No. Re'aSoirusi'ior Segregation - Date?of Segregation El ismtec?ve Custody Institution Security I: Medical Inmate Request 05715-2014 inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions inmate advised of opportuntiy for Interview with Superintendent Inmate waives opportunity for interview with Superintendent blame of SuperintendentIDeeignate (Print) SWMEWW Date sercunns g; 11-24-2014 I Superintendent Decision (This section must be completed within 5 days of the inmate's placent?nt in Segregation) Inmate submeslon 521(1) OWNE REQUEST. SIGNED REQUEST NOVEMBER 17TH. 2014Sugntendent Decision ReleaSe from Segregation - - Continue Segregation Reasonssee ems Rake?Se?: . Name at Superintendent-[Designate (Print) Date gems?317K loco Retrieilv Segregati?nto be reviewed everys days; interview we; inn-rate to'be conduoted evoryiiO days). in?elsubl??lssiqn' . - . 1 Supenntendent'Decision Release from Segregation - Continue Segregation 1 ReasonsSignature of Superimendenthesig-nate Date 15""2'3 I . .7 5 2'23; . I I Supplementary Report for'each Subsequent 30 Day Periodfuse reverse o?fonnrfaneddmonaioommentaComments Superintendentr?Design'ate Signature . m. ,4 .T- CSD 075-100 (10104) 000735 Reg?idnai Di'r??t'or Review Contin??ed Segr?ga?on 'Supborted Not Supported Ac; CAI {ar?l - . CL ??rm-09 A-QM I ?1 5?9 EDT {Jig?m?gl?lj 1mmM (Print) . ?Datg 94M can Supplemehtary Report for each Subsequent 30 Day Period (use bottom of form fo'nadditional comments - Comments Signature Date . - .CdnlinuedlAdditional Ccinin?iehts by Sl?rintend?ntlDesig?ate Qomments Slgnalure Date Continued/Additional Comments by Re'giori'al.DirectofIDesignat? .- Comments. ?Signalu?re . - CSD 075-100 (10104) imam 0mm - Regional cine-b: {day forRogional aim Rm: Copy-Immune 000736 Name (Last. First. Middle) Segregation DeciSiOnIRe?view Institution - .Central North Correctional Centre I Client Ioenti?catlon No. Segregotion Protective Custody Institution Security Medical Inmate Request Date of Segregation 10-03-2014 Inmate advised of reason for segregation Inmate adviaeo of opportuntiy for Interview with Superintendent Inn-late advised of opportunity to make oraI or written submissions - ,7 Inmate walves opportunity for?flntenitew with Superintendent NameotSupe?nlen?denUDesignate (Print) ngmi naie' - Date CURTIS 1 .. 11-24-2614 superintendent Decision (This section must be completed within 5 days? of the inmate?s ptacement in Segfagafiahown: REQUEST. INMATE SIGNED REQUEST NOVEMBER 2014: sup?iint?ndent Decieion Release from Segregation Continue Segregation Reasons: 4 91% E, Rang; . Name of (Print) - Date ?199927 (is 2 Segregation (Inmate's segregation to be reviewed every 5 days. with waste" to be twisted Siren/ab aim superintendent DeCision . El Release from S?eQwon El Continue Segregation 1 Superintendent?pe'eignate (Print) - - r, Date? I . Sup'piementafryR??H for e'?ai ?ube?quen't tasty I gametes" SuperintendenUDeslgnete Signature 1 Date MMidaiyy'yy .. CSD 075-100 (10I04) s.21(1) 000737 Page? . - Regidnai Dir?ctof?R?vi?w 7 Egg-linux26 Suppoer . Not Supported . ,r m" fallm 3/7 Na - 435m @mmredormesign Supplementary-Report for each Subsequent 30 Day Period (us? bottom of fo'r?additidnal comments Comments - Signature I Date Co?tidUedlAadi?ohal Comi??hts nyTSuper?interidentlb?signate Cgml?genjs Signature Date ContinueHIAdditio??l Comments; by-Reg?ional Directormesig??ate .. . . - . - Comme?nls? Signalqre Datp 1-, . - Distribution: Onn'nal - Rommel Dbroctor (Only forRegloncJ Dim ROW) Copy - Inmala Frle . 050 075-100 000738 '1 Segregation bedside/Review Ontario Institution iCentiai North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Reasonts) tor Segregation . Date?of Segregation [1 Protective Custon . Institution Security Medical Inmate 107032014 Inmate advised of reason for eegregation Inmate advised of opportuntiy for-interview with Superintendent inmate advised of opportunity to make oral or written submissions inmate waivesropportunity for interview with Superintendent Name of SuperintendentlDesignate (Print) Sign}! Wand jam - Date DESROCHES . gm j? 11-24-2014 - .. . Stiperint?nderlt Decision ibis section must be completed within 5 days of the inmate's piaow?erit in segredation) Inmate Suornisslon - OWNE REQUEST, INMATE SIGNED REQUEST NOVEMBER 17?, 2014. Superintendent Decision Reiea'se from'Segreg'ation m/ Contin'ue Segregetion Reasons: k?twg??S' I Name afsugemnagn?eggpammn - Date 1 too a i to be revieirreci every 5 days: 'lntenriew With inmate be ?onducted every 30 days) InmateSubmiesionSuperintendent Decision. 1] Release from segregation - - Continue Segregation' - Name '3 Signature oiSuperinteneenUpesignate Date Day .0 Comments 7 SuoerintenoenUDesignate Signature 7 Date I: 1 .- a. . CSD 075-100 (10/04) I s.21(1) - twin 000739 Regional Director Review I Page 2 Summit! .. El Not Supported Continued Segregation 7. Cor'nr?enis - (in U, .. ijo/ liq/146?: ~04 vegj/ Nam. al?lrectorlDesignatePrinti Si natu 'oniDireetorIDesignate' Date . 7/ MJ/Wcmara Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - - Comments . Signature Date . Continu?dlAdditiDnal Comments by Supetintenden?beei?nate Comments Signature pate . ContinuediAdditional Comments by Regional Director/Designate . i - Conan-tents I Signature . _Date - 050 075-100 (10104) Distribution: O?gnel - Mbn? 1m {Only forli Director-Review - lrI'natl Flla '000740 Segregation BedsiehiRevieW institution - Central North Correctional Centre A Name (Last. First1 Middle) Client identi?cation N0. Reason(_s) for Segrbgation i Date of Segregation Protective Custody El Institution Security Medical inmate Request . 10715-2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral_or written submis'sions Inmate advised of opportuntiy_far interview with Superintendent Inmate waives obpoitunitlfor lntervlevir with Superintendent Name of Superinte_ndenthesignate (Print) Sign re of 801' ilntende 7 nate 'Date SGT. DESROCHES I 11-24-2014 . . Supenntendent Decisron (This section must be completed within 5 dye of the inmate's pi?bement In 5' on) Inmatej?ubmission, - - .- owNE REQUEST. SIGNED REQUEST NOVEMBER 2014. juperintendent Decision Release from ma?on Continue Segregation .Reaep'ns: we? Name pf Superintepeenyeesignatataunt) . Date a .- .- 30,0022er 1 ?re'g? 'ati'??n Review (inmate 0.300030" to be reviewed 'eir?ry 5 days. iririiete t6 b?'c?hdudted ev'anr'SO days) viqmeesvhmiasipn- - -- - 5.. Superintendent Decision Release from Segregation El Continue SegregatiOn Name oiSUi?e-nntend??Vij?-i?m "f I Date Ii t; l. plementary Regan for-each'Subsequent 30,DayiPenod (use reverse offarm foreddiironelcamments) - . - Comments Superinte?dent?oeliisnet? Sisn?twe" ?"1331! n- . 4Mde (:60 015100 (10/04) s.21(1) VJ call/v.9 000741 RegionaI'Director?Review A Page 2 Cohtlnu'?d?SeAgre'g'a?on Supported Not Smned . 7 I ?1 CommentS" v? - . mac: m- . -. Name of nate (Prln orf?esng 4' . Supplementary Report for each Subsequent 30 Day Period (use bottom of form?for additional comments 7 Comments Slgnature Date . ContinuedIAdd'rtional Commehi? by Sup?rintend?nUDesignate Comments Signature Date I ContinuedlAdditional Comments by Regional - . -, - Comments. 7 Signature .Date . . . Distribution: Copy ?111313 Flle CSD 075-100 (10104) 000742 I. I I . 5.21 (1) - Segregation DecisionIReview . - Ontario I institution . Central North COrrectionai Centre Name (Last. First. Middb) Client Identification No. lH' . ID We Custody institution Security Medical Inmate Request 064072014 Iln'mate advised Iof reason for segregation Inmate advised of opportunity to make oral or written inmate advised of opportunity for interview with Superintendent inmate waives opportunity for interview with Superintendent Name of Superintendentlpeslgnate (Print) I Signet I - Date SGT. DESROCHES . .. 1/ 11.24-2014 SUpe'rintendent Decision (T his Section must be completed within 5 days of the inm'ete's'piacem?nt in' inmIate_$ubmi53lqn I . QWNERIEQUEST. INMATE SIIGNED REQUEST NOVEMBER 17TH, 2014. Su?ntendent Decision Release from Segregation - Continue Segregation Reasons: - I . WEE REWEX . Name 'of Suoerintendeni'IlDeIsignale (Print) Date . SEQ reggtion ReVIeW?nmaie's segregation to be reviewed every 5 days. Interview 'lnmatesubrnission - - - *Imp er/(Ig. with inmate to every 50 days) Superintendent Decieionv Cl Release from Segregation 1 Cl Con?nue Segregation #55655? 7 I Newofsupeiinteneenwesnnah (Print) - ?lamen- 9t$upe?hi?rden99e$?nate . leafs ?ui?biementaw Reportl?forj?e'ach Su?s?'qdent 30 Day Period {rise Meaghan" bf?d?diShhicbm?mhi?) . r. Commentem - - '5up_??ntendenUDeeignete Signatore Date -- CSD 075-100 (10104) 000743 Re'gio'nal Diredor Review Page 2 Continued Seme'ge?on SUppo?ed' Not Supported "'ts . . EL ox re?t/reg (?ame Name quEgion DireduriDesignate (Print) "teeter/Designate Date . o?i?wj ?/rCMwSuppl_ementary Report for each Subsequent 30 Day Period (use bottom of form for addItional comments Comments Signetuge Dale . . 'Continued/Add'rtienal SuperintendentiDesignate - Cdmm?ents Signature Date Mde/yyny - Continued/Additional Comments by Regional Director/Deeignate -- "Comments Signature Date I - Minion: Original - Regional binder (Only for Rachael Binder Rewind Copy lnmaia Fllo 050 075-100 (10/04) 000744 - Segregation DecieioniReuiew I Ontario Institution -- I Central North Correctional Centre 7 Name Middle) Client Identi?cation No. for Segregation Date of Segregation l] Prot?ctive Custody _D.lnstitution Security El Medic-2 Inmate Request - 09?24?2014 advised of reason for eegr'egatlon Inmate adulsed of opportunity to make oral or written eubmisSions inmate advised of opportuntiy for Interview with Superintendent a Inmate waives opponunity for interview with Superlntendent Name of SuperintendentIDesignate (Print) Wupennt entrDe?signat Date 11?24-2014 Superintendent De'oision {This section must be completed m?thin 5 days of the inmate's placement in seg're'?ation) Inmate Submission SIGNED REQUEST NOVEMBER 2014. Superintendent Decieion El Release from Segregation . Continue Segregation ReasonsWaite/<3 RQMEYC - 7 Date . - .. . ., . . - :3 - :1 'irl? _2 'i - 1., reghon REVIEW (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be'oonducred every 30 daysSuperintendent Decision Release from segregation - Continue Segregation - lName Date - .W - .IL..Supplementary Report for each Subsequent 30 Day Penod (use reverse arrorm foraddrboneicomments) -, - -, f~ :Cdmr?n?ents?i" '_?_upedntendenUDeelgnate Signature I gate - -- v: .- - 050 075-100 (10104) 1 s.21(1) 000745 Rgg'ionai Dire'ctere?oiew' Page 2 Continued Sgg? fag ation ?13: - Supported Not Supponegi comm-ms . El :WV?b/hg ray-re, W4 - ?mfg-nan [:i/r::r719nata (Print) ?le I . W??ww L. Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments . . Signature . page 00de Continuedl?ddit'ional Comments by Sub?rintend?ntIDesignat? - Comments . . . Signature Date . - - - DirectorlD?signat . A. - - - -- 4- Signatpre -- - Onmnal -Rog?ona Dlroctoy Copy- Innate F0. 050 075-100 (10104) 000746 . Se'gr?g??ti?n'begiSigtheview 70?qu . i - Institution . . c?ntkal North Correctional Centre _Name (Last. FirsL?Middle) Client Identi?cation No; ReqSon(s) for Segregation Date_ef segregation E1 [Ln-smu?on Security El Medlcal Inmate Request 09.24.2014 ?lhtz'na't?'ardyised of reath {of se?'i'iega'tieh I Inmate adviseci-of- agapenunlty to make oral or We}! subr?is?i0ns Inmate advised of opportumi?y interview with Superintendent . Ind-late waives oppd?unity lor intewiew with Supe?rintandenl Name Sig} of 'nteqdent} esign er Date SGT. CURTIS DESROCHES . . A 11-24-2014 . . . - .v - Sgperintehdent Decision "(inks sectiori must be corriplefed within 5 d?y?s? af?me In 5593mmth ,nmrate Submission - . . .7 .W. J. 7 . - 3.142 INMATEQWN REQUEST SIGNED NOVEMBER 17TH, 2014. I - s.21(1) 7. . Superintendent Deci?ion El Release from segrega?on El . Continue Segregation .Re816091ignate . Date' . 909271.14 .,Segregatlon ReVIew (Inmate?s segregation tube reviewed every 5days. Interview to be condan everySOdays) ilnmapSupnyifssio?nSuperintendent Bedsio?' 'j Release from segregation - 'Co?tinue' Segregation . .Name - - Date 1? 11-1 . ;Sh?hplem?ht?ry'Rebo'rtfoi?ach s?i?fbseq ?htao Day 7. . - "Commute." -. 'Sun?mendenvlaesmnatpswam?r Date . . .1 1 . MMldeYm. CSD 075-100 (10104) DEC 0 ?1 20111 V) A 000747 Page 2 . -Regioh?l Dire??tdn? R?view Co'n?nued Segregation Subported . Not Supported . r: - - mic/r 1/ . . Erector/Designate (Print) _Inala Date *4 63/15 Suppiement?ry Report?for each Subsequent 30 Day Period (use bottom of form for-additional comments Comments Signature Date - Mde/my Com'hwenis by SuberintendenUD?sign?te - - . I Comments Signature jpate . . R?gic'm'al DIre?ctor/De?ignate - . 7 I. .- . . - Signlatur'e - Data I - Baum: enema-Re?nnm Flle . CSD 075-100 (10/04) 000748 i 0ntari0' segregation institution . Centr?at North Correctionei Centre Name (Last. First. Minute) Client Identi?cation No. 7 hate of Segregation 10-09-14 Reasons) for _Segregalion - Protective Custody Institution Security . Medical Inmate Request Inmate advised of reason for se?regattonl . Inmate advised of oopor?ttmity to make oral or submis?ions a Inm?te advised of opportuntiy for Intennetv with Superintendent lnm'ato opportunity for interview with Superintendent Name'of Sdperintendentlpeeignate (Print) . Sirp?rintendent 'D?cision (This section must be completed within 5 dais of the innt'aie'splace'fnent In segregationinmate Submission inir is MENTAL NEEDS. QANNOT BE HOUSED WITH OTHER lvatATES AT THIS TitVlE. Superintendent Decision Release from Segregation -- CI rCon?nUe'Segregation 1v; a? mosey "?rst . ?To Steeraefs?trie?? I'Na'r'ne d_5upennrew?quq?mnm_gp?nt) - lumping. - '9 Date . -- n-LSegrengatIon Revrew (inmate's Segregation to be reviewed everxs days. interview mm rnmate to be conducted every 30 days) -- 7 c. I Superintendent Decision Reieasa from moon '.Cont_i_nue Segregation tangent - Merrie Signature ofsupgrin?tendemi eeignatq" Date {j :Comrpents?: . Data . . -_..deaim- . - cso oretoo (10104) DECO 1 204 8 s.21(1) 000749 Regional'Direotor Review - Page 2 Continued Segregation Qo'rn?roe'nls Suppoded 5? . EL fH-?m [nfdt Not Supported - c. win/i nate (Print) Name egionaI Director?Deslg ,4gz ,Luj 7 rfBesig na te Supolemeritary Report for each Sub?equ?nt 30 Day Period (use bottom of forth for additional oomments . Comments Signatora Date I Continu?dIAdditiohai Como-[ems by Superihtende??DeSignate 7 Comments Signaturg Date - - mum Conunu?d/Additao?al by Regional Direbtorroe?igu?te? - . . . 'comrpe'Slgnature .Date . cso 075-100(10104) paw-w: Origin! - Regional Dir-char (Oniy Ibr?egiunal Dir'IerRaofow) Gopy- Irma Fm 000750 .- sggf?gation DeCis'ioniReview "Omar-9 . a Inst'mtion . . .1 . ., i - . Central North Correctional Centre 7 . I Heme (Last. First. Middie) Client Identi?cation No. 8.21 (1 BeqsoMs) for Segregation Dateof Segregation Protec?ve?Custo'dy Institution Security El Medical Inmate Request SEP 14 A inmatejedvlsed of reason for segregation I Inmate advised of opportunity to make are! or Written 'submis'sions inn-rate advised of opponuntiy for Interview with Superintendent Inmate waives opportunity for intenrievv with Superintendent Name of supenntendentlpesignare (Print) Signatu of p_e nden ignat . Date SGT. 'cu?rims DESROCHES . 11?24-2014 (This. seotian have! be completedrwitnin days ?f?the'inniete's pietuimiant In segregation) Inmate gubmission? -n q-a - .TQ .si?eNINTb?-ca CANNQT MANAGE 16m AN GPELN. memo GIVEN THE AN. OPEN GPRANGE UM REFUSES. CITJNG THAT HE THAT "M's ARE-AWARE OF. A: ?Pf?zgvious's'EX'dFFiaNc?gHE CLAIMS-THIS IS THE FAULT Mc?scs. su??'r'inten'ctent Decision El i--Re ease from Segregation ?7 *m was ex: eme?mwo e07 mew?g ?o'to . I. turei Date mo ?2.51 CI Continue segregation ear-w 5.5. a ?i (51.: -- i. . . Segregation REVlew (Inmate's fsegregationtobe reviewed evary5days. interview with inmate to be conducted every 30 days) superintendent DeciSion' - Release from Segregation - CI Continue Segregation' Resegg 2' - 3 . I pate r. - . I Isup?lernentaiiy Repert tor-eeoh Subsequent 30 Day inerin (e58 inverse 1 .: Signature ?l .Datei,? 080 075-100 (10/04) DEC 0 1 14 6w 000751 Region?l Director Revi?w Se'gLegation ,Suppofted Not SupportedDirelctorfDes?gnate (Print) Date . I Supplementary Report for each Subseciuent 30 Day Period [use bottom of form for additional comments Comments Signature Date 1 - 'co'nt'inu?amddi?tionComment} '7 Signature - Pate - Mde Regional - . . .. scam? 3mm new. Diddhu?on: Dogma! - Regional Dim?Pr (Only for Roman! Dlm?nr RMW) Copy - mm Flt: CSD 075-100 (10l04) 000752 .- --Q.niarno . Segregation peois?ibn'lReView lnstitutlon Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. twosome) tor aggregation Date of Segregetlon Protedjve Cdstody El institutionSecurity El Medicel Inmate Request 7 . 08-25714 Inmate advised of reason for segregation inmate advised of opportunity to make oral or w'ritten submissions Inmate advised of opporuin?ciy forinterview with Superintendent Inmate waives opportunity for'intenrlew with Superintendent Name of Sign? eqf Su rlnteysig [e - Date SGT. . 11-25?Superintendent (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission - - TO REMAIN IN SEGREGATION. sape?mendem DedSionl Re'aase?bm segregaum El Continue Segregation '7 Reasons; . - t, I I see ?Km Rigger. Name?of .Suoe?ntendenupesigngte (Print) {fit-J 2f;- ?hrfSegregation Revnew {Inmate?s segregation to be reviewed every 5 days. Intemew With Inmate to Inmate'subrnissionw -- - - - -- - .- sign-ate Pate . my a . be ?cor'rducr?d ?t'r?ry 30 d?ys") .. S?oo??rintandentoecision Release Segreg?tion - - gon?nue.8egrege?on 8'21?) Reggae - - (Print) . - pate tiIf; Supplementary Report for;.each.Subsequent 30 Day Pernod (use reverse offarm foraodr?onalcommenrsComments . Supe?nhndewoesiggamSignature . :Qstej if? Eli-:1 .. csu 075-100 (10104) 000753 . Pagez Regionai DirectOr Review I - Cohtinued Se?regatidn Supported Comr?e?tg'. '1 4 gar-{Designatemrim 7 Supplefn?ntaty Report for ?ach Subseq'?ent 30 Day Period (use bottom 6fforin for additio??l comments Comments Signature Date . Conti?ulledlAddhid'nal Cdmment? 'by Superintehd?nUDeslgn?te . Comments . Signature . Data Mde/y?yr cantin'uediAdditional Comm?nt?s by Regional Dir'?thHD?Sigriate 1 . - 6- . :,c?mmenn .. .7 . .Slgnature D'at'el-. . cs0 075-100(10104) Won: angina! - Rook-ml {Only hr Regional binder Rawwj - Innate ?le . at 000754 . of Community Safety - - - . Ontarlo and Correctional Services segregatloh Dec's'oanewew In stltution Central North Correctional Centre Name (Last. First. MlddIe) Client Identi?cation No. Reason(s) for Segregatlon Date of Segregatlon [1 Protective Custody Institution Security El Medical Inmate Request 14-Aug-2014 _7 Inmate advised of reason for segregation In ate advised of opportunity to make oral or written submissions Inmate advlsed of opportuntiy for interview with Superintendent Ians opportunity for interview with Superintendent Name of SupenntendenUDesignate (Print) Sign-air ?eperintendentloesignate Date 30-Oct-2014 John Hanley Superintendent Decision (T his section must be completed within 5 days of the iacemen! in segregation) Inmate Submission Inmate requests to remain in segregation Sliperiritendent Decision Release from Segregation El Continue Segregation Reasons: \9 Ma- :33 RESP as"? ?Lo e?cto m-mmx?u?x. Name of Superintendent/Designate (Print) SignatLKme?ntenden?Designate Date 30-Oct?2014 John Hanley Segregation Review (inmate's segregation to be reviewed every 5 days. hammers to be conduotad every 30 days} - Inmate Submisslon Superintendent Decision Release from Segregatlon Continue Segregation Reasons: Name of SuperintendentlDesignate (Print) Signature of SuperlntendentlDosig?nate Date Supplementary Report for each Subsequent Day Eieriod (use reverse ?or form for" additional comments) Comments - Superintendent/Designate Slgnature Date Day! Month I Year Cso 075?100 (06199) 1w. (Mir/ s.21(1) 000755 Masterson. Chadwick 0539991022 Page 2 District Administrator Review, . Continued Segregation SLipported Not Supported Comments 3 - . ON Liv?J. Name; ict Administrator/Designate are of District AdministratorIDesignate I A?Clj?wi? Date 9' A Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments I - Comments Signature Date Day I Month I Year ContinuedIAdditional Comments by Superintendent/Designate - Comments Signature Date . I Day I MonthIYear . Continued/Additional Comments by District Administrator/Designate Comments Signature Date Day I Month I Year CSD 075-100 (05:99) Demitaution: Ongiml - Druid Admmiwucr (Only for Dism'd Admmua'atm Renew) Copy - Inmate File 000756 on; 0ntario and Correctional Services Ministry of Community Safety Segregation Decisioaneview Institution Central North Correctional Centre I Reason(s) for Segregation Name (Last. First. Middle) Client Identi?cation No? El Protective Custody institution Security CI Medical Inmate Request Date of Segregation 1?ch Inmate advised of reason for segregation Inmate advised of opportuntiy for interview with Superintendent Inmate dvised of opportunity to make oral or written submissions Inmate es 0 pgrtunity for interview with Superintendent Name of SuperintendentiDosIgnate (Print) John Haniey Signature of enUDesignate Date 30-Oct-2014 Superintendent Decision (This section must be completed within 5 days of the inmati'g plac?nent in segregation) Inmate Submission Inmate requests to remain in segregation Simenntendent Decision Release from Segregation Continue Segregation Reasons: muk??'gx Ragga?- S-aorc?gak?tP-Q- Name of SuperintendenttDesignate (Print) John Hanley- I . . 4 Date 36-Oct-2014 Segregation Review (inmate?s segregation to be every 5 days. Interview With inmate to be conducted every 30 days) Inmate Submission Superintendent Decision El Release from Segregation Continue Segregation Reasons: Name of SuperintendentiDesignate (Print) Signature of SuperintendentiDeslgnate Dare Supplementary Report for each Sobsequent 30-Day Period (use reverse of. form for additional comments) Comments SuperintendentIDesignate Signature Date Day I Month I Year . 39H . 521(1) 050 075-100 (DGIQQ) 000757 Page 2 District Administrator Review Continued Segregation Supported Not Supported Comments a of District AdministratarfDesignate (Print) a orfDesignate Date . MK \ngwifk Supplementary Report for each Subsequent 30 Day Period (use bo?omnts I 00mments . Signature Date Day I Month I Year Continued/AdditionaI'Comments by Superintendent/Designate Comments Signature Date . Day! Montleear ContinuedIAdditionai Comments by District AdministratorIDesignate Comments Signature Date Day! Month/Year Distribudon: Origimil - Dism: {Only Dr's?n'ct Administrator Harlow) Copy - Frio CSD (06199) 5.231(1) 000758 Ministry of Community Safety re 'on Dec" vie and Correctional Services seg gat' Is'onIRe Ontario Institution Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Reason(s) tor Segregation Date of Segregation El Protective Custody institution Security 1] Medical Inmate Request 29-Aug-2014 Inmate advised of reason for segregation In ate advised of opportunity to make oral or written submissions Inmate advised of opgmuntiy for interview with Superintendent Inm tm'opportunity for interview with Superintendent Name of SuperlntendentlDesignate (Print) Signatu tSupertntendentIDeslgnate Date I 30-Oct-2014 John Hanley Superintendent Decision {This section must be completed within 5 days or chement in segregation) inmate Submission Inmate requests to remain in segregation Superintendent Decision El Release from Segregation Continue Segregation Reasons: l-I_ met? 55 RE I 2 Name ofsupenntendenUDesignate (Print) _ignatu of SuperintendentlDesignate Date L. John Hanley i 30-Oct-2014 . . . . . . i: - . . . . segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation - Continue Segregation Reasons: Name at SuperintendentiDeslgnate (Print) SlgnatUre of Superintendent/Designate Date Supplementary/Report for each Subsequent 30 Day Period (use reverse of fonnr?or'addr'tr'onat ?omments) Comments SuperintendentIDesignate Signature Date . Day.? Month I Year cso 075-100 (06199) s.21(1) 000759 Page 2 . . . District Administrator Review Continued Supported Not Supported Comn'ients Cur-P)? \w Qp?? . Name of Di?trict AdministmtorfDesignate (Prim) Administrator/Designate Date 6? Supplementary RepOrt for each Subsequent 30 Day Period (Use bottom of form for additional comments Comments Signature Date Day I Month I Year s.21(1) . Continued/Additional Comments by SuperintendentlDesignate Comments . Signature Date Day I Year Continued/Additional District Copy inmate File cs0 075-100(05199) 000760 . Ministry of Community Safety - - - 0 ntarlo and Correctional Services segregatlon Dee's'ganeVIew Institution Central North Correctional Centre Name (Last First. Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation CI Protective CustodL institution Security Medical Inmate Request 22-Aug-2014 Inmate advised of reason for segregation opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Ejnmat aives opportunity for intenriew with Superintendent Name of SuperintendentIDesignate (Print) John Haniey Signmumw?nden?nesignate Date i 30-Oct?2014 Superintendent Deeision (This section must be completed within 5 days of the inma i cement in segregation) inmate Submission inmate requests to remain in segregation Superintendent Decision CI Release from Segregation. Reasons: I Continue Segregation .. fen ?ve-3} ??66 t3 Name of SuperintendentlDesignate (Print) Signature Superlntendenthesignate Date soon-2014' John Henley Segregation Review (inmate's segregation to be reviewed every 5 days. intervieWmate to be conducted every 30 days) . 7 Inmate Submission Superintendent Decision El Release from Segregg?on Continue Segregation Reasons: Name of Superintendenthesignate (Print) Signature of SuperintendentlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse oi? form for additional comments) Comments SuperlntendenUDesignate Signature Date Day I Month I Year CSD 075-100 (00199) OCT 3 i 2014 (J 521(1) 000761 Page 2 I District Administrator Review Continued Segregation 5E. Supporled Not Simpoded Cammenis El I rid Administrator/Designate (Print) 5-21 (1 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Designate Date .1 . .21 2 Comments Signature Date Day I Month IYear ContinuedlAdditional Comments by Superintendent/Designate Comments Signature Date . . . . DallMontleear ContinuedlAdditional District Signature CSD 075-100 (06199) 000762 I . Ministry of Community Safety - . .7 Ontarlo and Correctional Services segregation Institution Central North Correctionai Centre Name (Last. First. Middle) Client Identi?cation No. Iul Date of segregation Protective Custody Institution Security [3 Medical inmate Request 18?sep'2014 Inmate advised of reason for segregation Inmat advised of opportunity to make orator written submissio ns Inmate advised of opportunity lor interview with Superintendent Inmate bat opportunity for interview with Superintendent 5.21 (1 Name of Supe rintendentIDesiQnate (Print) Signature of twnt/Designate Date 5.21 2 John Henley 30-Oct-2014 Superintendent Decision (This section must be compieted within 5 days of the trim cement in segregation) Inmate Submission Inmate requests to remain in segregation superintendent Decision El Release from Segregation Continue Segregation Reasons: ?\st Ter- 537% :30 Nugn?scc?x? NameofSuperintendentIDesignate (Print) Slgnature Sup endentrDesignate Date John Hanley 7 30-Oct-2014 segregation Review {Inmate's segregadon to be reviewed-every 5 days. InteMeero be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation . . >14 - Continue Segregation Reasons: Name of SuperintendentJDesignate (Print) Signature of SuperintendentJDesignate Date 1 Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendenUDesIgnate Signature Date Day I Month I Year (350 075-100 (06:99) 000763 District Administrator Review Page 2 Continued Segregation Supported Not Supponed Comck. ,mmi Sig natur ct Administrator/Designate I I Data Vishnu AdministratorIDesig nate (Print) (elm/J lawn/huch 'd 1 Supplementary Report for each Subsequent 30 Day Period (use arm or additional comments Comments Signature Date Day I Month I Year ContinuedIAdditionai Comments by Superintendent/Designate Comments Signature Date . Day [Month [Year Continued/Additional Comments by District AdministratorfDesi nate - Comments Signature Date Day I Month [Year Distribution: Origind - Di-tnd Administrator (Only forDist Administrator Review) Copy - Inmate File (:30 075100 (116199) s.21(1) 000764 Ministry of Community Safety and Correctional Services Segregation DecisionIReview Institution I Ontario Central North Correctional Centre Client tdenti?rztion No. I Name (Last. ?rst, Middle) Reason(s) for Segregation Date of Segregation . . . . . 25-Jul-2014 18 Protective Custody Institution Seounty Medical Inmate Request Inmate advised of reason for segregation In 3 advis of opportunity to make oral or written submissions Inmate advised of opportuntly for Interview with Superintendent Inm aives opportunity Ior Interview with Superintendent Name of SuperintendentlDeslgnate (Print) Signet of perlntendentIDasignate Date Jeh'n Hanley 30-Oct-2014 Superintendent Decision (This section must be completed within 5 days ofthe Mamment in segregation) Inmate Submission Inmate requests to remain in segregation Stiperintendent Decision Release from Segregation Continue Segregation Reasons: I PC and Admin hold due to natureof her charges :33}:th 1323566? We 5 "to em ex; Nameof SuperintendantlDeslgnate (Print) SignatuRer-intendenmesignate Date John H'anley 30-Oct-2014 lnmateSubrnission. Sgr'egation Review (Inmate's segregation to be reviewed every '5 days. lntem'eWbe conducted every 30 days) - Continue Segregation Superintendent Decision - [3 Release from Segregation - - Name at SuperintendentlDesignate (Print) Date Signature of SuperintendenUDesignate Supplementary lieport for each Subsequent 30 Day Period (use reverse of form for? additional comments) . Comments Superintendent/Designate Signature Date Day I Month I Year (:50 075-100 (OGIQQ) am 3 1? ?pgej/ce loo] 521(1) 000765 District Administrator Review Pagez Continued Segregation a? Supported Not Supported Comments ear-wt wiwistrict Admin' tratorIDesignate(Pnnt) i k- - Sign istrict Administrator/Designate . Supplementary Report for each Subs'equent?30 Day Period (use bottom of form for additional comments Date Comments Signature Date Day I Month [Year i ContinuedIAdditional Comments by Superintendent/Designate . Comments Signature Date Day I Month I Year ContinuedIAdditional Comments by District AdministratorIDesi nate Comments Signature Date 7 Daryl Month I Year . - Distribution: Original - Disirid Administrator (OnIy for District Rev-ow) Copy - inmate File cso 075?100 (05199) s.21(1) 000766 - . Ministry of Community Safety - - . . . Ontario and Correctional Services segregatlon DeF's'oaneweW Institution Central North Correctional Centre Name (Last, First. Middle) Client Identi?cation No. Reason(s) for Segregation El Protective Custody Einstitution Security Medical Inmate Request Date of Segregation 29-Aug-2014 Inmate advised of reason for segregation Inm advised of opportunity to make oral or written submissions Inmate advised of ggportuntiy for interview with Superintendent Inmate es opportunity for Interview with Superintendent Name of SuperintendentlDesignate (Print) Signature rintendenllDesignate Date John Hanley 30-Oct-2014 . Superintendent Decision (This section must be completed Within 5 days of the inmate's placement in segregation) Inmate Submission Inmate to remain in segregation adminsttative hold Superintendent Decision El Release from Segregation - Continue Segregation Reasons: . mowetx-am?Ctoa keen . To (599$ Wat?7? . . Name of Superintendenthesignate (Print) Signet of uperlntendentlDesignate Date . 30-Oct-2014 John Hanley I S?g regation Raview {inmate's segregation to be reviewed every 5 days. Intervieanate to be conducted every 30 days} Inmate Submission Superintendent Decision El Release from Segregation l3 Continue Segregation Reasons: Name of SuperintendentIDesignate (Print) Signature of SuperintendenUDesignate Data Suppfementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendentIDesignate Signature Date Egy I Month I Year CSD 075-100 (W99) OCT 3 1 201') 521(1) 000767 PageZ . . Eii?f?adg?gfi?; Supported :1 ?rammed ??3pr game; rams; A \u?x \nil\ QWM qh? of AdministratorlDesignate (Print) Signaiure of ra orlDesignate-I baie 5 I - s.21(1) wa WW 6 5.2mm) Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Day I Month I Year Continued/Additional Comments Su I Month [Year Continued/Additional District Admin IManLh I Year Copy A Inmate Fire CSD 075-100 (06199) 000768 I Ontario Minis? "fcmmun'ty safety. Segregation DecisionIReview and Correctional Services Institution Central North Correctional Centre Name (Last. First. Middle) 7 Client Identi?cation No. Reason(s) for Segregation Date oi Segregation Protective Custody Institution Security Medical inmate Request 16'sep'2014 Inmate advised of reason for segregation Inm te advlsed of opponunlty to make oral or written submissions Inmate advised of opportunu'y for interview with Superintendent Inrna elves opportunity for interview with Superintendent name of SuperintendentJ?Designate (Print) Signatu uperintendentlDesignate Date John Henley - 30-Oct-2014 Superintendent Decision (T his section must be completed within 5 days of the in segregation) Inmate to remain in segregation administrative hold Superintendent Decision Release from Segregation Continue Segregation Reasons: ken?uh . N-uamee?ek .- TWTS. SW. Name of Sup'erintendentlDeslgnate (Print) Signature erintendentIDeslgnate Date John Hanley - 30-Oct-2014 Segregation Revrew (Inmate ?s segregation to be reviewed every 5 days. interview with Inmate to be conducted every 30 days) Inmate Submission Superintendent Decision El Release from Segregation I2 Continue Segregation Reasons: Name of SuperintendentIDestgnate (Print) I Signature of SuperintendenilDeelgnate Date . Simplementary Report for each Subsequent 30 Day Period (use reverse of form for-additional comments) Comments 'SuperintendentrDeslgnate Signature Date Day I Month I Year 075100 (Dares) 0m 3 i 20"? I 521(1) . {my a? 000769 District Administrator Review Page 2 Continued Segregation Es Supported Not Supported 4w 04;" El mistsm?wk? I Nf District AdminiitratorlDesignata (Print) Signature We (14 at; I Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additmnai comments Comments Signature Date Day I Month I Year Continued/Additional Comments by SuperintendentIDesignate . Comments Signatore Date Day I Month I Year ContinuedIAdditionai Comments by District AdministratorIDesignate comments Signature Date Day I Month I Year Dls?'lbu?lian; Orith - mm: Ainil'tatrltor (Only for Mad Admrhistrator Review) Copy Inmate File can 075-1ch (05199) 521(1) 000770 and Correctional Services . . M'I't'fc - -- Ontano mm? 3? Segregation DecusuoniRevnew Institution - Central North Correctional Centre I Name (Last. First. Middle) Ciient Identi?cation No. Reasonis) for Segregation Date of Segregation Protective Custody Institution Security El Medical Inmate Request zwep'zou Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity for interview with Superintendent Inmate ways: onur?y for intenriew with Superintendent Name of SuperintendentIDesignate (Print) Signature of Su tendentIDesignate Date John Henley 30-Oct-2014 Superintendent Decision (This section must be completed Mann 5 days of the inmament in segregation) Inmate Submission Inmate requests to remain in segregation Superintendent De'cision Release from Segregation - Continue segregation Reasons: withName of Sumnntendenthesignate (Print) Slgnat?re perintendenUDesignate Date John Hanley . 30-Oct-2014 segregation Review (Inmate's segregation to be retii?wod every 5 days. Int?rvieMnate to be conducted-eyed :30 days) Inmate Submission .1 .21 (1 3.21 Superintendent Decision [1 Release from Segregation Continue Segregation Reasons: - Name of Superlntendenthesignate (Print) - Signature of Superintendent/Designate Date Supplementary Report for eachASubsecyent 30 Day Period (use reverse offon'n for additionai comments) 7 Comments Superintendenthesignate Signature Date Day I Month I Year 050 075-100 (06199) OCT 3 i 201?: 4 ES) 000771 Page 2 District Administrator Review Continued Segregation Supported . Not Supported Comments cm I ?1 yr Cw/rmuc/ 7720; Name of 'a AdministratorIDesignate (Print) . a mm MC Sign ?stratorlDesignale 0 ate Supplementary Regrt for each Subsequent 30 Day Period (use bottom of form for additions! comments Comments Signature Date Day I Month i Year Continued/Additional Comments by Superintendent/Designate . Comments Signature Date Day I Month I Year Continued/Additional Comments by District Administrator/Desi nate . Comments Signature Date I Day! Month I Year Distribution: Ong'irei - District Administrator (Only forDism'd Adminer Review) Cooy - Inmate File 050 075-100 (06159) 521(1) 000772 Ministry of Community Safety and Correctional Services Ontario Segregation Decision/Review institution Central North Correctional Centre Name (Last. First. Middle) -Reason(s) for Segregation Protective Custody CI Institution Security Medical Inmate Request Client identi?cation No. Suit-.201 Date of Segr a ion - 7 inmate advised of reason for segregation inmate advised of opportunity to make oral or written submissions Inmate advised of giportuntiy for interview with Superintendent Weir/es opportunity for inlenriew with Superintendent Name of SuperintendentlDeslg nate (Print) Sign of Superintendent/Designate Date John Haniey 30-Oct-2014 Superintendent Decision (This section must be completed within 5 days or the in placement in segregation) Inmate Submission - inmate requests to remain in segregation Superintendent Decision Release from Segregation Continue Segregation Reasons: News ?ames?r- To ?_?ccs ?seat.ch Name of SuperintendentIDesignate (Print) hJohnHanMy Signatur of uperintendenUDesignete Date 30-Oct-2014 inmate Submission . Segregation Review (inmate's segregation to be reviewed every 5 days. lntemMmate to be conducted army 30 days) Superintendent Decision . Release from Segregation El Continue Segregation Reasons: i Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Comments Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) . SuperintendentiDesignate Signature Date Day i Month Wear cso 075.100 OCT 3 i 2014 5 eel/2W5, 1% s.21(1) 000773 District Administrator Review Page 2 Continued Segregation EL Supported Not Supported UV Commeqis I ch.? m? gu?fyd? Lcnk?oJ Name i?trict AdministratorIDesignate (Print) Signature of District nate Data . 3? Sugplementary Report for each Subsequent 30 Day Period (use bottom 0? form tor aE'HT?onaI comments Comments Signature Date Day I Month I Year Continued/Additional Comments by Superintendent/Designate - Commens Signatu'ra' Date Day I Month I Year ContinuedIAdditional Comments by District Administrator/Designate Comments Signature Date Day I Month I Year Distributlm: Origins - Disrict Administrator DistnictAd-?ninistrator Review; . Cow - Inmate Flt: s.21(1) 050 075-100 (OSIBS) 000774 - Ontario Ministry of Community Safety and Correctional Services segregatlon Institution Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Reasan(s) for Segregation Protective Custody El Institution Security Medical Date of Segregation 23-Aug-2014 Inmate Request inmate advised of reason for segregation rtunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate opportunity for Interview with Superintendent Name of SuperintendentiDesignate (Print) Signature of rIntendent/Designate Date JOhn Haniey 30-Oct-2014 Superintendent Decision {This section must be comgeted within 5 days of the inmaiMi in segregation) Inmate Submission Inmate requests to remain in segregation Limit: 8?1,er gettiEEQATTQi-b i . . . . 521(1) SupenntendentDecrsron Release from'Segregation - Continue Segregation Reasons: UL Name of SupenntendentlDesignate (Print) Signature of Sup IntendonuDesignate Date John Haniey 30-Oct-2014 Segregation Review (inmate's segregation to be reviewed every 5 days. Interview withgimato I) be conducted every 30 days) Inmate Submission . I Superintendent Decision Release from Segregation Continue Segregation Reasonsf Name of Superintendent/Designate (Print) Date Signature of Superintendent/Designate Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SupenntendentlDesignate Signature Date Day I Month 1 Year 650 075-100 (06199) 000775 District Administrator Review Page 2 Continued Segregation 5 Supported Comments fU/Iacrk} a, #1 Not Supported Name/of AdministratorIDesignate (Print) w. Date he er. rib/4% Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Day I Month I Year ContinuedIAdditional Comments bLSupenntendentIDesignate Comments Signature Date Day I Month [Year ContinuedIAdditional Comments by District Administrator/Desi nate Comments Signature Date Day I Month I Year Distribution: Origina- - District Administrator {Only for Adnunr'stritorRaviow) Copy - Inmate File sec 075.100 (name) 521(1) 000776 . A SegregatiOn Decision/Review . Ministry of CommunitySafety Ontario and Correctional Services 7 . Institution Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Date of Segregation Reasonis) for Segregation Protective Custody El Institution Security Medical Inmate Request 18-Aug?2014 Inmate advised of reason for segregation I Inmatgadvised of opportunity to make oral or written submissions inmate advised of op'portuntiy for interview? with Superintendent lnmat es-opportunity for interview with Superintendent Name of Superintende I'ItlDeslgnate (Print) Sig nature uperintandenUDesignate Date John Henley A: 30-Oct-2014 Superintendent Decision (This section must be completed within 5 days or the ianacement in segregation) Inmate Submission Inmate requests to remain in segregation - Continue Segregation Superintendent Decision [3 Release from Segregation - - Reasons: Rims Rag-ex? Tm SW. r?R?g gecmgce-r'qiqg Name 'of Superintendent/Designate 7(Print) John- Hanley Signature rintendentlDesignate Date I I i i' 1 30-Oct-2014. - Segregation Review (inmate's segregation in be reviewed every 5 days. Intenrr?ew with ate to be conducted every 30 days) Inmate Submission Superintendent Decision Eli Release from Segregation Continue Segregation . Reasons: Name of SupenntendentlDosignate (Print) Signature of Superintendent/Designate Date Supplementary Report ?for?each Subsequent 30 Day Period i?use reverse "of for?additiona-l commentsi - Comments Su?perintendentlDesignate Signature 7' Date Dajl Month 1? Year a - CSD 075-100 (03799] OCT 3 1 2012. W/?wim 521(1) 000777 District Administrator Review Page 2 Continued Segregation Supported Not Supported Comments ex Name rid Administrator/Designate (Print) (QLJ C- dminislratorfDesignate Sign Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Day I Month I Year ContinuedlAdditional Comments by Superintendent/Designate Comments Signattire Date . I Day I Month I Year Continued/Additional Comments tgy District Administrator/Desi nate - Comments . Signature Date Day! Month IYear Distribution: Orig nal - District Adm'nisn'ttor (Only for District Admrm'strator Review) Copy - Inmate Fae cso creme (05:99) 000778 . I - Fri-.3 0 . Ministry of Community Safety - . . . ontano Segregation DecrsronIRevrew and Correctional Services Institution . Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation Protective Custody Institution Security Medical - Inmate Request 04-JUI-2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submiSsions Inmate advised of opportuntiy for interview With Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Supe endentlDesignate . Date _Sgt. M.J.Breslin . . 24-Sep?2014 Superintendent Decision (This section must be completed within 5 days o/tjzinmate's placement in segregation) Inmate Sdhmiss'ion Wishes to remain in segregation. Seg. cleaner 5.1 s.21(Superintendent Decrsron Release from Segregation . . Continue Segregation Reasons: a - Remain segregation. - Cuc?od'fjk boxer-?ES . LWEBK . Name of SupenntendentiDesignate (Print) Signatugaf Superinter?emmglignate Date WSIIW Qwedccx ?g 24-Sep?2014 . . - U. f. . ?7 Segregation Review (Inmate's segregation to be' reviewed every 5 days. Interview with inmate to be' conducted every 30 days) Inmate Submission Superintendent Decision - . Release from Segregation Continue Segregation Reasons: Name of Superintendent/Designate (Print) Signature of Superintende'ntlDesignate. Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date Day I Month I Year 0010 3 2w. - 050 075-100 (06I99) ?g 000779 . page 2 District Administrator Review \Deil ?@128 I Continued Segregation Supp?rted Not Supported Comments - iWMJ?s-?i?? Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date Dom}. Supplementary Report for each Subsequent 30_ Day PeriOd (use bottom of form for additional Comments Comments Signature Date Day I Month! Year Continued/AdditiOnal Comments by Superintendent/Designate Comments I 7 Signature Date - DaylMontleear' Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date Day 1 Month I Year Distribution: Original - District Administrator (Only for Distnci Administrator Review) Copy - Inmate File CSD 075-100 (06l99) 000780 I 673 Ontario Ministry of Community Safety and Correctional Services Segregation Decisioaneview Central North Correctional Centre Name (Last, First. Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation Protective Custody Institution Security El Medical Inmate Request 24?sep-2014 inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) - Signature of Superintendent/Designate Date 24-Sep-2014 Superintendent Decision (This section must be completed within 5 day the inmate's placement in segregation) ?lnmate Submission. Fears for safety-own request Superintendent Decision Release'from SggregatiOn CE Continue Segregation Reasons8&3 F45.) 5.14 2 var-C sag: - 1 Name of SuperintendentlDesignate (Print) Sig of Superintendent/misman Date . I i . 5.2 Wk 999* ?i - . Se re atron REVIEW (lnmate'sjsegregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) - inmate Submission Superintendent Decision El Release from Segregation El Continue Segregation Reasons Name of SuperintendenUDesignate (Print) Signature of SuperintendentlDesignate Date Supplementary Report for each Subsequent '30 Day Period (use reverse of form for additional comments) Comments SuperintendentIDesignate Signature Date Day I Month I Year cso 075-100 (06l99) 0 2 201'. (MW 000781 Page 2 District Administrator Review AA . Continued Segregation 95?} Supported I Not Supported Comments \vwivk? Name of District Administrator/Designate (Print) Signature of District Administrator/Designate MC Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Day I Month I Year ContinUed/Additional Comments by SuperintendentIDesignate . Comments i Signature Date - i . Day I Month I Year ContinuedIAdditional Comments by District Administrator/Desi nate Comments Signature Date Day I Month I Year Distribution: Original - District Administrator {Only fer District Administrator Review) Copy - Inmate File CSD 075-100 (06I99) 000782 i Ontario Ministry of Community Safety and Correctional Services Segregation Decis ion/Review InstitUtion Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. - Reason(s) for Segregation Protective Custody Institution Security Medical Inmate Request Date of Segregation 24-Sep-2014 Inmate advised of reason for segregation Inmate advised of opportuntiy for interview with Superintendent Inmate advised of opponunity to make? oral or written submissions Inmate waives opportunity for interview with Superintendent '7 . Signature of Superi tendentiDESign?aK Name of Superintendent/Designate (Print) Signature of erinlendenUDesignate .D'ate' __39t.M.J.Breinn' . 24?Sep?2014 Superintendent Decision (This section must be completed within 5 days 0M inmate's placement in segregation) Inmate Submission - - - - - Fears for safety-own reduest I 5.21(1) Superintendent Decision - ReleaSe from Segregation IE. . Continue segregation 8:21am) ReasonsDeg KG: EARS ?gg' -- . a es" . Name of Superintendent/Designate (Print) Date Inmate Submission Se'g' reg ation Review ?(inm'ateis' segregation. :6 be reviewed every. 5 days. Interview with inmate to be conducted every "36 day's) 13,, i Superintendent Decision - Release from Segregation Continue S?greg? atiOn Reasons: Name of SuperintendentiDesignate (Print) Signature of SuperintendentiDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendentiDesignate Signature Date Day I Month I Year CSD 075-100 (06199) 0 000783 DiStrictlAdm'inistrator Revievr(0\oq \?mul wer? - Continued Segregation - E: SLipported Not Supported CommeMs - Name of District Admi-nistratorIDesignate (Print) Signature of District Administrato ID signate Date Suppiementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments "Comments Sr Signature Date Day/?MonthIYear r, Continued/Additional Comments by Superintendent/Desigiate . 'Comments Signature Date 7 . . - - Day.IMonthIYear Continued/Additional Comments by District Administrator/Desi nate Commems sanmum Dme Day I Month I Year Distribution: Original - District Administrator (Only for District Administrator Review) Copy - Inmate File cso 075?100 (05199) 000784 - - s.21(1) - I I . . Ministry of Community Safety - - - - - OHta and Correctional Services segregatlon DeclSlonIRev'ew Institution Central North Correctional Centre Name (Last. First. Middle) (Client Identi?cation No. - .Reason_(s) for Segregation - - - Date qt Segregation El Protective Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised oflopportuntiy for interview With Superintendent Inmate waives opportLinity Ior'interview with Superintendent Name of Superintendent/Designate (Print) Signature of Su erintendentlDe'signate Date t. . . . I 24-Sep-2024 Superintendent Decision (This section must be compietednwithin 5 days inmate's placement in segregation) Inmate Submission 7 . . . Wishes to remain in segregation Superintendent DeciSion CI . Release from Segregation - . . . >14 .. . Continue Seg?gation ReaSOns: . . - . Remain segregatiOn :42) we atName of SuperintendenUDesignate (Print) - 1 Signature of Superintendwe I Date I \wibkvk -. sep+13[tte SQ r? ?tidn Rewew "Mae's Sbg?ega?o? i0 5?5 even! 5 days.? mien/raw with inmate to be conducted ever 30?da'ys) Inmate Submission . a Superintendent DecisiOn . Releaseifrdm Segregation 7. . Cl Continue Seg?gation Reasons: Name of SuperintendentlDesignate (Print) Signature of SuperintendenUDesignate Date Supplementary Report for each Subsequent 30, Day Period (use reverse of form for additional comments) Comments . Superintendent/Designate Signature Date Day i Month I Year DU 080 075-100 05,99 . 000785 District Administrator Review (?adj-ax Continued Segregation a; ijgdw? Comments Not Supported Name of District Administrator/Designate (Print) I Signature of District Administ orlDesignate 'Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments I i Comments Signature Date Day /_Month I Year COntinued/Additional Comments by Superintendent/Designate Comments 7 Signature Date - . 1' Day/Mentleear' Continued/Additional Comments by District Administrator/Desi nate Comments Signature - Date Day I Month I Year Distribution: Original - District Administrator {Only tor District Administrator Review) Copy - Inmate Fite CSD 075-100 (06I99) 000786 - s.21(1) - Ministry ?f c?mmunity Safety - Segregation Decision/Revievii'zmm 0 "ta 0 and Correctional Services - Institution Central North Correctional Centre Name (Last. First. Middle)_ Client Identification No. _Reason(s) for Segregation Protective Custody institution Seourity El Medical Date of Segregation 14-Aug-2021 Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportunity for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of Signtendentmesignate Date _S_gt.7M.J.Bresiin 24-Sep-2014 Superintendent Decision (This section must be completed within 5 days ofwinmate's placement in segregation) Inmate Submission - Wishes to remain in; segregation until court completed. Superintendent Decision Release from Segregation Continue Segr_e'gationl .. (g Re'asOns: . Remain segregation until court completed or sufficent time between court appearances to permit transfer Re:er Gimme?(D35 6.0 %mc_ sis. arc-3v yes?cf; och Name of Superintendent/Designate (Print) Signature'ofSu erinte'ndentlDesignate Date - I 24-Sep-2014 Manon Rewew (?mate's Segr?g?tton ?0 be eVery 5 days. Alrview with inmate to be conducted every 30 days) Inm?le Submission - . . Supjenntendent Decision Release from'Segregation? _ContinueSegregation.? Reasons: Name of SuperintendentIDesignate (Print) Signature of SuperintendentlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Date Day 1' Month I Year Comments Superintendent/Designate Signature OCT BTW weal/(cg; 080 075-100 (06i99) 000787 District Administrator Review (fa-C? Continued Segregation Supported Not Supported V: NIL Comments l-?x (?Wale-J JP Name of District Administrator/Designate (Print) W9 Wrap/?i 5: Signature of District Adrn'inistra [Designate y) Date - . Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional'comments 7 Comments Signature Date ?Day I Month I Year Continued/Additional Comments by Superintendent/Designate Comments Signature 'Date Day I Month I Year Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date Day I Month I Year t? Distribution: Original - District Administrator {Only for District Administrator Review) cso 075-100 (06199) . Copy - inmate File 000788 i . s.21(1) - - Ontario Ministry of Community Safety Segregation Decisioaneview and Correctional Services Institution Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Reaisontsiior Segregation Date _of Segregation 8 Protective Custody El Institution Security Medical inmate Request 24'Sep'2014 Inmateadvised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview ?with Superintendent Name of Superintendent/Designate (Print) Signature of SuperintendentlDesignate Date SQt.M.J.Breinn 7m . 24-Sep-2014 Superintendent Decision (This section must be completed within 5 days inmate 's placement in segregation) Inmate Submission - -V - - - - Fears for safety-own request Superintendent Decision . Release from Segregation . - .., . Continue Segregation Reasons: tows-b 093k)- Rgguceg"? SVKB - Name ure Date I t3. useueck - sent ar??i Segregation segregation to be reviewed every 5 days. interview with inmate to' be Connected even/3O days) Inmate Submission - . . Superintendent'Deci?sion Release from Segregation . . . Continue Segregation Reasons: .Name of Superintendent/Designate (Print) . Signature of SuperintendentlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date Day I'Month [Year 050 075-100 (OBISS) 000789 District Administrator Deview (a Q9 moire D. Continued Segregation g] Supported Not Supported - Name of District Administrator/Designate (Print) Si nature of District AdministratorlDesignate Date - .r I Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments - Signature Date Day I Month I Year Continued/Additional Comments by Superintendent/DeSignate Comments Signature . Date Day I Month I Year COntinued/Additionai Comments by District Administrator/Desi nate Comments Signature Date DayI Month I Year Distribution: Original - District Administrator (Only for District Administrator Review) Copy - inmate File CSD 075-100 (06/99) 000790 a Ministry ?of Community Safety and Correctional Services Ontario Segregation Decision/Review Institution Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. Reason(s) for Segregation Protective Custody Institution Security Medical Inmate Request Date of segregation 24?Sep-2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Date Name of superintendent/peeignate (Print) - Signature of Sup rintende?ntlDeSignate I Date Sgt.M.J.Breslin I - 24-Sep-2014 . I I . Superintendent Decision This section must be completed within 5 days 70% inmate 's placement in segregation) Inmate Su'bmisSion . . .. . Fears for safety-own request Superintendent DeCis'ion El Release from Segregation . ?Continue Segregation. . . Reasons: .7 .k - .I . ?qxtm gt. ,0 KEEQULLA 3:011 - gerre?Tg - *m Name of Superintendent/Designate (Print) Sign of Su? ant/Desight\ mecca-AK .. my .1 Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be'conducte'd every 30 days?) Inmate Submission - .r I 564% 25/0} s.21(1) . I I . - "Superintendent Decision Release from Segregation . ContinUe Segregation CI Reasons: Name of Superintendenb'Designate (Print) Date I Signature of Superintendent/DeSignate Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) . Comments Superintendent/Designate Signature Date Day I Month I Year OCT 0 2 201% CSD 075-100 (061'99) 000791 Page 2 District Administrator Reyiew (Q0 . [j Not Supported Continued Segregation EQ siphoned Comments - Mme: est?m5 Name of District AdministratorlDesignate (Print) Date Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additionat comments - Comments Signature Date Day IMonth I Year. Continued/Additional Comments by Superintendent/Designate Comments Signature Date . Day! Month I Year Continued/Additional Comments by District AdministratOrlDesi nate - Comments Signature Date - Day I Month I Year Distribution: Original - District Administrator (Only for District Administrator Review) Copy - Inmate File (:50 075-100 (05199) 000792 . I . Ministry of cemmunity Safety . Orltal'lo and Correctional Services s.21(1) Segregation Decision/Review Institution Central North Correctional Centre Name (Last. First, Middle) Reason(s) for Segregation Protective Custody Institution Security Medical Inmate Request Client Identification No. Date of Segregation 24-Sep-2014 Inmate advised of reason for segregation Inmate advised of opportuntiy for inteniiew with Superintendent Inmate advised of opportunity to make oral or written submissions inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignate (Print) Signature of Sup 'ntendentlpesignate Date Sgt.M.J.Breslin' MI 7 . 24-Sep-2014 Superintendent Decasron (This section must be completed within 5 days oi?h?nmate's placement in segregation) inmate Stibmission i Fears for safety-own request Superintendent DeciSion - Release from Segregation Continue Segregation Reasons: . I . eases, see ?ag . Name of Superintendent/Designate (Print) Date I Signa of Superinte U9esignate - I SEgregation Review (inmate's segregation to be reviewed every 5 days. interview With inmate to be Conducted every 30 days) inmate Submission Sepi? (a Superintendent Decision Release.from Seg?gation I 7 Continue SegEgatiori Reasons: Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) . SuperintendentlDesignate Signature Comments Date Day I Month I Year CSD 075-100 (06199) 000793 Isage 2 District Administrator Revie Oi i CI Continued Segregation Supported Not Supported Comments 3M5 Name of District Administrator/Designate (Print) MC ?Plum-C?? Signature of District AdministratorIDesignate Ki) Date (Jul/4M Period (use bottom of form for additional comments) Supplementary Report for each SUbsequent 30 Day Date. Comments Signature . _7 Day I Month I Year Continued/Additional Comments by Superintendent/Designate Comments Signature Date DaylMonthiYear I Continued/Additional Comments by District Administrator/DeSignate Comments Signatore Date Day I Month I Year Distribution: Original - District Administrator (Only (or District Administrator Review} CSD 075-100 (06/99) Copy Inmate File 000794 and Correctional Services - . . Ministry of Community Safety - - . i Ontano I Segregation Decrsmanevrew Institution Central North Correctional Centre Name (Last. irst, Middle) Client Identification No. Reason(s) for Segregation - . Date of SegregatiOn Protective Custody El Institution Security Medical Inmate Request 24?sep-2014 Inmate adviSed of reason for segregatiOn Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate Waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) . Signature of Super" ndenUDesignate Date Sgt.M.J.BreSIin . 24-Sep-2014 Superintendent Decision (This section must be completed within 5 days of thi j/mate?s placement in segregation) Inmate Submission I Fears for safety?own request Superintendent Decision - - - Release from Segregation .E . ..Continue Segregation Reasons: - i i 2. Reg%_% . tag Name of Su'perintendentiDesignate (Print) Signet of Superinte ntng'StgneK Date (322 - 369+ Segregation Review (Inmate's segregation to be reviewed every 5 days. lnienriew with inmate to be conducted every 30 days) Inmate Submission . $.11 . .21 (1) Superintendent Decision El Release from Segregation . E) 7 Continue Segregation 5 .1 Reasons: . Name? of Superintendent/Designate (Print) Signature of SuperintendentlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendentlDEsignate Signature Date Day 1 Month I Year . 001 0 2 2015 (:50 075-100 (06(99) 6 . Ty 000795 Continued Segregation (EL Supported Not Supported . 3 I I District Administrator Review QM I Comments . Quart)? \?no-aoi" Name of District Administrator/Designate (Print) Signature of District AdministratorIDestgnate Date \Mptc-~ Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date - Day I Month I Year Continued/Additional Comments by SuperintendenUDenggte Comments Signature Date Day I Month I Year . Continued/Additional Comments by District Administrator/Desi nate Comments . Signature Date Day I Month I Year Distribution: Original - District Administrator (Only for District Administrator Review) Copy - Inmate File C50 07 5- 1 00 (06/99) 000796 Ministry of Community Safety and Correctional Services Ontario s.21(1) Segregation Decision/Review Institution Central North Correctional Centre Name (Last, First. Middle) Client Identi?cation No. Reason(s) for Segregation Protective Custody Date of Segregation 24-Sep-2014 El Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of'opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Sgt.M.J.Breinn Signature of Superintendentlpesignate Date 4144/ 716 24-Sep-2014 . . Superintendem (This section must be completed within 5 days of (h inmate's placement in segregation) Inmate Submission - Fears for safety-own request SuperintendentDecIsio Release from Segregation Continue Segregation Reasons: - up?: Owe teem-em . We Fell W3 3W5- Name of SuperintendenUDesignate (Print) A endentlDESignate Date Wupe Segregation R?vi?w (Inmate's segregation in be reviewed. every 5 days. Interview with inmateto be conducted every 30 days) Inmate Submission . . Superintendent Decision- Release from Segregation - . Continue Segregation Reasons: Signature of SuperintendentlDesignate Name of Superintendent/Designate (Print) Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date Day I Month I Year OCT 0 2 14' CSD 075-100 (06l99) 000797 Page 2 District Administrator Review Dem i 3 1% El Continued Seg?gation 8? ?suppoi'ted Not Supported Comments . AIR - Name of District Administrator/Designate (Print) Signature of District AdministratorIDesignate Date Dew) (oz/1 Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments - Comments Signature Date . Day I Month I Year Continued/Additional Comments by Superintendent/Designate Comments Signature Date Day I Month I Year Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date Day I Month I Year Distribution: Originat - District Administrator (Only for District Administrator Review) Copy - Inmate FiIe CSD 075-100 (06I99) 000798 and Correctional Services . Ministry of Community Safety . . . . ontano segregation DecrsronIReVIew - I institution Central North Correctional Centre Name (Last. First. Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation Protective Custody El Institution Security Medical Inmate Request 24?Sep-2014 Inmate advised of'reason for segregation Inmate advised ofopportunity to make oral or written submissions inmate advised of opportuntiy for interview with Superintendent I Inmate waives opportunity for interview with Superintendent Name of SuperintendentiDesignate (Print) Signature of SuperintendentiDesignate Date Sgt.M.J.Bresiin . 24-Sep-2014 Superintendent Decision (This section must be completed within 5 days? inmate 's placement in Segregation) Inmate Submission - - - Fears ro'r safety-own request Superintendent Decision . El Release from Segregation . . . . Continue Seglegation . - . I, - - r' . ReasOns; Illa: Name of SuperintendentIDesignate (Print) Date . 're ation" R?Vi'ew (inmate's segregation to be reviewed every 5 days. Interview With'inmate to be conducted every 30 days) Inmate Submission -- - . - . . I Superintendent Decision CI Release frOm Segregation . Continue Segregation. .. . - t. Ll 'Reasons: Name of SuperintendentiDesignate (Print) Signature of Superintende'ntlDesignate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendenUDesignate Signature Date Day I Month I Year s.21(1) 0CT0720 050 075-100 (06/99) 5 000799 District AdminiStrator Reviewf Qt;th E: 5% continued Segregation p'ported Not Supported Comments 3N3 QWW Name of District Administrator/Designate (Print) NC (Oahu 5; Signature 0 trict Administrator/Designate Date Supplementary Report for each SUbsequent 30 Day Period (use bottom of form fbradditional comments) I Comments Signature Date - Day I Month I Year Continued/Additional Comments by Superintendent/Designate Comments 7 Signature I Date v? . iDayIMonth/Year . Continued/Additional Comments by District Administrator/Desi nate i Comments Signature Date Day I Month I Year Distribution: On'ginai - District Administrator (Only Ior District Administrator Review) Copy - Inmate File CSD 075-100 (06I99) 000800 I i . Ministry of Community Safety - - - i - - . Lontano Segregatron?DecrsronIRevrew and Correctional Services Institution Central North Correctional Centre Name (Last. First. Middle) 7 Client Identi?cation No. Reason(s) for Segregation I Date of Segregation Protective Custody Institution Security Medical Inmate Request 24-8ep-2014 Inmate advised .ofqreason for segregation Inmate advised of opportunity to make o'r_a or written submissions Inmate advised of opportunliy for interview with Superintendent Inmate waives opportunity for interview with Superintendent I Name of Superintendent/Designate (Print) Signature of Sup? 'ntendentlDesignate Date ?gt.M.J.Bi'eslin . 24?Sep?2014 Superintendent Decision (This section must be completed within 5 days of tgnmate?s placement in segregation) Inmate Submission - - Fears for safety-own request Superintendent?DeCision Release from'Segregation - .Er. . .~..Continue Segregation- Reasons: I - "~Vu 5000 Eda tax-can Date I islame of SuperintendenlIDesignate (Print) .W ag/M Segregation Review (Inmate?s s'egregaiion to be reviewed every Sidays.? Interview with inmate robe conducted every'3o days) Inmate Submission . I . i 5.21 (1) Superintendent Decision -- Release from Segregation . A EL . Continue Se?gation V?Reasons: Name of SuperintendenUDesignate (Print) A Signature of SuperintendentIDesignate' Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments SuperintendenllDesignate Signature Date Day I Month I Year 7 It can 075100 (06199) @359,? 000801 . . Page 2 District Administrator ReView( MK 9? NADA Contintjed Sup?orted Not Supported Comments Cuppnw Mei? 9% Name of District Administrator/Designate (Print) - I 67.th 3/1906 ZOIH ?iM new? 5mm 2 awu?kemsr? may? sergeants) s.21(1) JUL 3 1 201), 050 075-100 (06/99) - 000827 Page District Administrator Review Continued Segregation Supported . 'Not Supported Comments - aw Kt? plaza 'En?nn?u Name of District AdministratorIDesignate (Print) Signature of District AdministratorIDesignate Date - - -. . I I 707 W, 261? Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments - Signature Date 1 1A . . Dathonth/Year V??f 621% /0 [19? l? - - I Continued/Additional Comments by Superintendent/Designate '1 Comments- Signature Date . Day I Month I Year I 521(1) 521mm - Continued/Additional Comments by District Administrator/Designate Comments Signature Date Day I Month I Year np'w -m Distribution: Original - Disiricl Adminislrator (OnIy for District Administrator Review) Copy - inmate Fila CSD 075-100 (06I99) 000828 Kr ontario Community Safety and Correctional Services Segregation DeciSion/Review Institution Central North COrrectional Centre Name (Last. First. Middle) Client identi?cation No. Reason(s) for Segregation Protective Custody institution Security Medical Inmate Request Date of Segregation 08/1 2/2014 Inmate advised of reason for segregation Inmate advised of 0pp0rtuntiy for interview with Superintendent Inmate advised of opportunity to make oral or written submissions Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) M.J.Breslin, Signature of Su erintendent/Designate Date 10/06/2014 . Superintendent Decision (This section must be completed within 5 days of the inmates placement in segregation) Inmate Submission - inmate fears for Safety Superintendent Decision Continue Segregation Reasons: El Release from Segregation Name of SuperintendentiDesignate (Print) 24/50 Date (0/07/24/9/ Segregation Review (inmate's'segrega'tion to be reviewed every 5 days. Inten/iew with inmate to be conducted every 30 days) inmate Submission Superintendent Decision Release from Segregation El - continue Segregation Reasons: - Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date 521(1) CSD 075-100 (10/04) 000829 . Page 2 District Administrator Review Continued Segregation Supported I I Not Supported I, Cm I raj . fag/t Comm- Name of District Administrator'iDesignate (Print) Signature of District AdministratorlDesignate Date - (j 5 Supplementary Report for each Subsequent 30 Day PeriOd (use bottom of form for additional comments) Comments Signature Date Continued/Additional Comments bySuperintendenUDeSignate Comments Signature . Date . Continued/Additional Comments by District Administrator/Designate Comments Signature Date i Distributidn: Original - District Administrator {Only for District Admini'stratOr Review) Copy - Inmate File CSD 075-100 (10/04) 000830 by'3. I and i Segregation Decision/Review . I A Ol'rec Iona erVIceS Ontario i Institution Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. Reason(s) for SegregatiOn I I Date of Segregation i:i Protective Custody CI Institution Security Medical Inmate Request 08/14/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent E-lnmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date M.J.Breslin, . . . 10/06/2014 Superintendent Decision This section must be completed within 5 days of placement in segregation) Inmate Submission Inmate fears for safety Superintendent Decision Release from Segregation . . Continue Segregation Reasons: - Date xc??w/a/ Name of SuperintendentlDeSignate (Print) Signature Segregation Review (Inmate's segregation to be reviewed every '5 days. interview with inmate to be conducted every 30 days) Inmate Submission . - . - Superintendent Dedision Release from: Segregation . El Continue Segregation Reasons: i I - s.21(1) Name of Superintendent/Designate (Print) i Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) - Comments Superintendent/Designate Signature Date CSD 075-100 (10/04) I 000831 District Administrator Review I Page .2 Continued segregation El Not Supported Comments or? f4 Supported Era/J (an/:qu (WCet/?nJ 9?1) AAIU Name of District Administrator/Designate (Print) Signature dministratorlDesignate 'Date /;rcAwJ ?c/M Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments I Signature Date - Continued/Additional Comments by Superintendent/Designate . Comments Signature Date Continued/Additional comments by District Administrator/Designate .Comments Signature Date i: CSD 075-100 (10/04) Distribution: Original - District Administrator (Only for District Administrator Review) Copy_ - Inmaze File 000832 Segregation DeCisioaneview Iona erVIces Ontario institution Central North Correctional Centre Name (Last, First, Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation . . . . [23/2014 Protective Custody institution Security Medical Inmate Request 08 inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions inmate advised of opportuntiy for interview/with Superintendent Inmate waives opponunity for interview?with Superintendent Name of Superintendent/Designate (Print) SignatuWerintendent/DeSignate - Date M.J.Breslin, - 10/06/2014 Superintendent Decision (This section must be completed within 5 days of thwmate?s placement in segregation) Inmate Submission . Inmate fears for safety Superintendent Decision Release from Segregation - K4 Continue Segregation ReasonsName of Superintendent/Designate (Print) I Signature of Superintendent/Designate Date Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to Decor/ducted every 30 days) inmate Submission I - . Superintendent Decision. Release from Segregation? Centinue Segregation Reasons: 7 521(1) Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date cs0 075-100 (10/04) 000833 District Administrator Review Page 2 Continued Segregation i Supported . . Not Supported Comments ,fu Par/Z99 Cup/(Quid; C.ch VJ A fr? NameofDBUmtAmnmEandDesgnme(an) Dam gczaoj (Dd-wen Supplementary Report for each Subsequent 30 Day Period (use bottom of form additional comments) Comments Signature Date Continued/Additional Comments by Superintendent/Designate . - CommeMs Sgnmum Dme 4. Continued/Additional Comments by District Administrator/Designate . Comments Signature Date Distribution: Original - District Administrator {Only for District Administrator Review) Copy - lnma=e File CSD 075-100 (10l04) 000834 My) - Community Safety and Segregation Decision/Review Zr. Ontario Correctional Servnces . I Institution 7 Central North Correctional Centre I Name (Last. First, Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation . . . 08/12/2014 Protective Custody Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions - Inmate advised of opportuntiy for interview W?t Superintendent El Inmate waives opporttnity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date M_J.Breslin, a . 10/06/2014 Superintendent Decision (This section must be completed within 5 days of Mnmale's placement in segregation) Inmate Submission 1 . Inmate fears for safety Superintendent Decision 'Release from Segregation - . Continue Segregation Reasons: Name (of Superintendent/Designate (Print) Signature of Date J7 MW 4/1150 4/ Segregation Review (Inmate's segregation to be reviewed every 5 days. Interv/e? with inmate to be condiJcted every 30 days) Inmate Submission - . Superintendent Decision. Release from Segregation Continue Segregation Reasons: - s.21(1) Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date 030 075?100 (10/04) kg 000835 Page,2 District Administrator Review Continued Segregation Supported Comments El (?apper/j 54A Air-.2113] It; [6/1,th Name of District Administrator/Designate (Print) Signature of Dis ?"Date Supplementary Report for each Subsequent 30 Day Period (use_bottom of form for additional comments) Comments Signature . Date Continued/Additional Comments by Superintendent/Designate - Comments Signature .Date i i i i Continued/Additional Comments by District Administrator/Designate Comments i Signature Dale i i Distribution: Original - District Administrator (Only for District Administrator Review) Copy Inmate File CSD 075-100 (10/04) 000836 - safe?! and Segregation Decision/Review Ontario Correctional Servrces . - - Institution Central North Correctional Centre Name (Last; First. Middle) Client Identi?cation No. _Reason(s) for Segregation Date of Segregation . . /1 812014 Protective Custody Institution Security El Medical Inmate Request 08 Inmate advised of reason f0r segregation El Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Su'perintendentlDesignate Date M.J.Breslin,' 10/06/2014 Superintendent Decision This section niust be completed within 5 days of th mate's placement in segregation) Inmate Submission Inmate fears for safety Superintendent Decision EL Release from Segregation . Continue segregation Reasons: Name of SuperintendenUDesignate (Print) - Signature of Date /o/57/2,o/L/ I 14/4350 Segregation Review (Inmate's segregation to be reviewed every 5 days interview with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision [1 Release from Segregation. Continue Segregation Reasons: Name of SuperintendentlDesignate (Print) Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date . s.21(1) cso 075-100 (10/04) Q, 000837 Page, 2 District Administrator Review Continued Segregation A Supported . N01 supported Comments Gangtuu/ Ami/I] Crvaw? Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date . 7? A a I I Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Continued/Additional Comments by Superintendent/Designate . . Comments Signature - Date - . MM/dd/?yyr Continued/Additional Comments by District Administrator/Designate . Comments I Signature Date I i 1 Distribution: Original - District Administrator (Only for District Administrator Review) Copy Inm'a-e File CSD 075-100 (10/04) 000838 PP) and Segregation Decision/Review . orrec Iona ervrces . - . Ontario - - Institution Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. Reason(s) for Segregation - Date of Segregation . . . . I 1 I 14 Protective Custody El Institution Security Medical Inmate Request 08 9 20 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or writtensubmissions Inmate advised of opportuntiy for interviewyyith?iperintendent Inmate waives opportunity for interview with?Superintendent Name of SuperintendentlDesignate (Print) Signature of Superintendent/Designate Date M.J.Breslin. be 10/06/2014 Superintendent Decision (This section must be completed within 5 days oftth nrnate's placement in segregation) Inmate Submission Inmate fears for safety Superintendent Decision" Release from Segregation COntinLie'Segregation Reasons: I I . 7 Name of Superintendent/Designate (Print) Date Segregation Review (Inmate?s segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission - . - . Superintendent Decision Release from Segregation . 7 Continue Segregation Reasons: . - s.21(1) Name of Superintendent/Designate (Print) I Signature of Superintendent/Designate Date Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date CSD 075-100 (10104) 000839 Page, 2 District Administrator Review Continued Segregation Supported Not Suggorted Comments Aoufiq] Id?? Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date I Supplementary Report for each Subsequent.30 Day Period (use bottom of form for additional comments) Comments Signature Date Continued/AdditionalCemments by Superintendent/Designate Comments Signature I Date Continued/Additional Comments by District Administrator/Designate Comments i Signature Date - Distribution: Original - District Adminislrator (Only for Distn'ct Administrator Review) Copy lnma File CSD 075-100 (10/04) 000840 n. - . . Ministr?yotCommunlty Safety - - - - ontano Segregation Decrstoanevrew and Correctional Services Institution 7 Central North Correctional Centre Name (Last, First. Middle) Ciient Identi?cation No. _Reason(s) Ior Segregation Date of Segregation Protective Custody El Institution Security Medical Inmate Request ?01 -Jl,Jn-2014 Inmate advised of reason for segregation I inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunijyior interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superin?tend 'gnate Date Angt. 8. McNeil . a 24-Jun-2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in Segregation) Inmate Submission . Inmate requests to remain in segregation. superintendent Decision, Release from Segregation Continue Segregation Reasons: Inmate fears for safety. . Name at Superintendent/Designate (Print) Signature of SuperintenftUDe ignate Date 30?Jun-2014 NSgt. S. McNeil 7 Segregation Review (inmate's segregation to be reviewed every 5 days. trit?m?ew with inmate to be conducted every 30 days} Inmate Submission Inmate requests to remain in segregation. Superintendent Decision Release from Segregation . Continue Segregation Reasons: Inmate fears for safety on an open range. Name of Superintendent/Designate (Print) . Signature of Superintendent/Designate I Date i Urie?jLMJ I 7 Supplementary Report for each Subsequent 30 Day Period {uq?j?versefof form foradditionat comment?s) Comments SuperintendentlDesignale Signature Date . - . . Day I Month [Year WA '10 mam submarine: HIS t3. - - Gusto . i 6 - 59.7. worm?1 - JUL 3 1 znii CSD 075-100 (OEIQE) 5.21 (1) 000841 . District Administrator Review. Page 2 Continued Segregation [11/ Supported Not Supported Comments Name of District AdministratorIDesignate (Print) Signature of District AdministratortDesignate Date Adm 25 I 201 I Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additionai comments) Comments Signature Date Day I Month! Year ContinuedIAdditionat Comments by SuperintendenUDesignate Comments Signature Date Day I Month I Year Continued/Additional Comments by District Administrator/Desic nate . Comments Signature Date - Day I Month I Year lit-1.. IMUM- 07/99/8041 Distilbutton: Dnginal - Administrator Copy - Inma CSD (Only for Admmistmtor Rainan In Ito 521(1) 000842 . Ministry of Community Safety 3 Ontario and Correctional Services Segregation Decisioaneview' Institution Central North Correctional Centre Name (Last. First, Middle) Client Identi?cation No. nuabuntai IUI ougicgauun Protective Custody Institution Security Medical Inmate Request Date of Segregation 15-May-2014 Inmate advised otreason for segregation IE Inmate advised oiopportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) msgt. s. McNeil Signature of Superint esignate Date 24-Jun-2014 Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission I Inmate requests to remain in segregation. Continue Segregation Superintendent Decision Release from Segregation - Reasons: Inmate fears for safety. Name at superintendent/Designate (Print), Signature 0! Superint esignate Date un-2014 Angt. S. McNeil Segregation Review (inmate's segregation to be reviewed every 5 days. inteM'ew with inmate to be conducted every 30 days) InmateSubmission Inmate requeSts to remain in segregation. Continue Segregation Superintendent Decision Release from Segregation - Reasons: Inmate fears for safety on an open range. Nameof uperintendenUDesignate(Print)- I Signature of Supe ntendentlDesignate Date Mam,?- . q??fl? Supplementary Report for each Subsequent 30 Day Period (u5{e.rqlerse of form for additional comments) Comments 7 Date Day {Month Year \il? 9kg ukn'u. C.me FOR. I Rb. enema is Ranges-7Q. 5w. cumin Z: :qu Mqum sow mu:? tr-we mus cso 075.100 (Dares) 3 1 . s.21(1) 000843 Page 2 District Administrator Review Continued Segregation Supported Not Supported Comments ?Lula VIM Name of District Administrator/Designate (Print) Signature of District AdministratorIDesignate Date SupplementaryReport for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Day I Month I Year Continued/Additional Comments by SuperintendentIDesignate Comments Signature Dale 5-1 . Day I Month I Year s.21(1) Continued/Additional Comments by District Administrator/Desi nate Comments Signature Date . . Day I Month] Year it?? aim-04? Mtg20/:7' Distribution: Original . Disuii: Administrator (Oniy (or District Rev-ow) Copy - Inmate File 650 075-100 (06199) 000844 I Dntario Ministry of Community Safety and Correctional Services Segregation Decision/ReView Institution Central North Correctional Centre [Tame (Last. First, Middle) Client Identi?cation No.? Reason(s) tor Segregation Protective Custody I: Institution Security Medical Inmate Request Date of Segregation 16-Jan-2014 Inmate advised of reason for segregation Inmate advised of opportuntiy for interview with Superintendent Inmate advised of opportunity to make oral or written submissions a Inmate waives opportunity for interview with Superintendent . Name of SupenntendenUDesignate (Print) - SMnt/Oesignate Date 24-Jun-2014 NSgt. s. McNeil Inmate Submission Inmate requests to remain in segregation. Superintendent Decision (T his section must be completed within 5 days otthe inmate's placement in segregation) Superintendent Decision Release from Segregation Continue Segregation Reasons: Inmate fears for safety: Name of SuperintendenUDesignate (Print) s. McNeil. Signature oiSuperinte en esignate Date 30-Jun-2014 Segregation Review {inmate's segregation to be reviewed every 5 days. Interview with inn-late to be conducted every 30 days) Inmate Submission - Inmate requests to remainin segregation. cs0 075-100 (05199) JUL 3 I 2111!. Superintendent Decision Release from Segregation 7 Continue Segregation Reasons: I I I i I Inmate fears for safety on an' open range: Name olSuperinlendenllDesignate (Print) 1 Signature of SuperintendentiDesignaie ?7 A I Date .W?rmsuReport for each Subsequent-30 Day Period (use [?rse of form for additionai comments) I Comments Date 7 i . I - DayIMontleear . ?im mews we gets. m- um) I - - mow: Home Uthth estate Mob 7 )ui?s ugw CM .uoubMP?' 'liMh Ml 521(1) 000845 .rP Page 2 District Administrator Review A Continued Segregation 8? Supported Not Supported Comments . . Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date (I, I .0, '5!me Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additionai comments) Comments Signature Date Day I Month I Year ContinuedIAdditional Comments by Superintendent/Designate Comments Signature Date Day! Month I Year Continued/Additional Comments by District Administrator/Desi nate - Comments . .Signature Date 7 Day I Month I Year (m?ynqk?. zuL?aqafD {Di?g?/Quyy 0119qu - Awnmislraior {Only far Administrator Review] Copy - Inmate Filo CSD 075-100 (06199) s.21(1) 000846 Ontario Ministry of Community Safety i i and Correctional Services segregat on Dee's'oanev ew Institution Central North Correctional Centre Reason(s) for Segregation Name (Last. First. Middle) Client Identi?cation No. Data at Segregation 03-Apr-2014 Protective Custody I: Institution Security Medical Inmate Request Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy Ior interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendentlDesignate (Print) Signature oISu'peri en ntlDesignate Date . 7 24-Jun-2014 Angt. 5. McNeil Superintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission - Inmate requests to remain in segregation. Superintendent Decision Release from Segregation Continue Segregation Reasons: Inmate fears for safety. Name of SuperintendentiDesignate (Print) S. McNeil 30-Jun-2014 Segregation segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) . Inmate Submission Inm'ate requests to reinain in segregation. Continue Segregation Su'perintendentDeCision Release from Segregation . . Reasons: Inmate fears for safety on an open range. Name of SuperintendenUDesignate (Print) Signature of Supeytmesignate Date (25551? 7 . . 7/9/09Supplementary Report for each Subsequent 30 Day Period (use r?tfse of form [or additional comments) Comments VSupenntendenttDesignate Signature Date . . DaylMonthIYear . own Jae-nurse: ?3 meat. min .19 (Lemt'giio sec; in 'Arr HIS mot? PUk?cgmmi?, it me. wry CSD 075-100 (06199) s.21(1) 000847 a <3 Page 2 District Administrator Review - Continued Segregation [:l/Supported CI Not Supported Comments . amt i - 5.14 2 843* th VHS 9. . s.21(1) Name of District AdministratorlDasignate (Print) Signature 01 District AdministratorJDesignate Date 521 Luand- g?uaj [Ir Supplementary Report for Each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Dayl Month I Year ContinuedIAdditional Comments by SuperintendenUDesignate Comments Signature Date - Day I Month Year Continu?dlAdditidnal Comments by District Administrator/Designate, - . i' - Comments Signature Date Day I Month I Year LmMap?m; - Onginal Damn Administrator {Only [or Rania-n} Copy - Inn-into Fitu C50 075-100 (06195) 000848 Segregation Decision/Review institution KENORA JAIL . Name (Last. First, Middle) Reasonts) for Segregation El Protective Custody Institution Security Medical I El Inmate Request Client identification No. Date of S?gregdtion 441? Inmate advised of reason for\eegregation inmate advised of opportunity forinterview with Superintendent Inmate advised of opportunity to make oral or written submissions Inmate waives opportunity for interview with Superintendent Name ofSuperintendenUDeslgnate (Print) Signature of Su jir?nu esignate Data LSMITH 5 ?1 1/1012014 Superintendent Decision {This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission Superintendent Decision Release from Segregation Continue Segregation Reasonsmic (311 Name of Superintendent/Designate (Print) Date Slfu of SuperintendenUDesignate it 11/52.; inmate Submission . -. 1" . Segregation Revrew (inmate?s segregation to be reviewed every 5 days. interJ?giVWn?aie to be conducted every 30 days) Sugarintendent Decision Cl Release from Segregation Continue Segregation Reasons: (17(24th Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date - I 9/ 3? Iterator mm . PL . Supplementary Report for each Subsegient 30 Day Period (use revere %r redditronei comments) . Comments perintendentiDestgnate Signature Date Wage/?ow 0V1 It?! M73 A ?eld - lie 080 075-100 (10104) s.21(1) 000849 Regional DirectOr Review Page 2 Continued Segregation Supported Not Supported .ZL Comments Cart A: . 6k ?3 t7. (AA a-immrqu Name of lonal DirectortDesignate (Print) VAC c? Date Sup?ementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date . . 1 I34 Craft? 50 ctrot m# 566. To (?q/?69K arr? .. A/z Acid Continued/Additional Comments by SuperintendentJDesignate Comments Signature Date ContinuedIAdditional Comments by Regional Director/Designate Comments Signature Date . Original - Regional Director (Only {or Regbnat Director Review) Copy - inmate lie (:50 075-100 (10104) . . 000850 prntario Segregation Deci sioaneview Institution KENORA JAIL Name (Last, First. Middle) Client Identi?cation No. - Reason(s) forSegregatio r-x, i Protective Custody Institution Security Medical @lnmate Request Date of Segregation 11l13l2014 Inmate advised or reason for segregation Inmate advised of oppoduntiy for interview with Superintendent Inmate advised ol opportunity to make oral or written submissions Inmate waives opportunity for interview with Superintendent Name of SuperintendentiDeslgnate (Print) LSMITH Signatugsgp?tendenUDesignate Date 11/13/2014 Superintendent Decision This section must be completed within 5 days of the inmate's placement in segregation) Inmate Submission S?erintendent Decision El Release from Segregation Continue Reasons: smart/Lark (?77,0ka for) (J [Dy/Mama,? Name of SuperintendentiDesignate (Print) .4111 ad, Ham/2m Date . . Review (inmate's segregation to be reviewed every 5 days. to be conducted every 30 days} Siggatur; ot SgslerintendenUDesignate l/K_ 7r Inmate Submission Superintendent Decision Cl Release from Segregation Eb Continue Segregation Reasons: #70 J10 main /0 O??ld?d (-111 gig/abut Signature of Su erintendenUDesignate Name otSuperintendenti esignate (Print) Date ("War i. . a - ?r ng?/i 6 7i. i 77-7 Supplementary Report for each Subsequent 30 Day Period (use reve??r additionalcomments) Comments SuperintendenUDesignate Signature Date I W7 L. 2.. 7173?" amt/{g CSD 075-100 (10104) a I, I 434:9] -sr' DEC 1 8 21m s.21(1) 000851 Regional Director Review . Page 2 Continued Segregation CE Supported Dr Not Supported Comn?ients . Purify/IL; 211 0ner tin-j ?11 x. NamegLReW DirectorIDeslgnate (Print) Signature of Date '7 - rc/ZW Mme/c: L. gja 0 Supplementary Report for each Subsequent.30 Day Period (use bottom of form for additional comments) Comments . Signature Date - Continued/Additional Comments by SuperintendenUDesignate Comments Slgnature Date Continued/Additional Comments by Regional DirectorlDesignate Comments Signature Date Distribution: Original - Regional Director (Only forRegional' Director Review) Copy - Inmate File CSD 075-100 (10104) 000852 . Segregation Decision/Review ntarlo Institution Kenora Jail Client identification No. Name (Last, First, Middle) Reasonts) for Segregation Date of Segregation [3 Protective Custody Institution Security Medical Ci Inmate Request 08/29/2014 Inmate advised of reason for segregation Inmate advised oi opportunity to make oral or written submissions Inmate advised of opportunity for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of SuperintendenUDesignaIe (Print) Signa erlntendentiDesignate Date Steve Walker I i . 10/16/2014 er - Stgnerintendent Decision (This section must be completed within 5 days of the inmate's placement in segregation) inmate Submission - I Superintendent Decision Release from Segregation Continue Segregation Reasons: Still on Suicide watch Name of Supe'rintendentiDesignate (Print) Signature of SuperintendenUDesignate Date Steve Walker I Zoe Roblin . 10?16?2014 Segregation Review (inmate's segregation to be reviewed every 5 days. interview with inmate to beconducted every 30 days) Inmate Submission (ELL. . Superintendent Decision Release from Segregation 13" Continue Segregation .f a see 3 we dean Mia Mice ?Fia? A A Name oWen?Desi nate (Print) .- ?31:?ure of?Sup tende Designate Date -, Supplementary Report for eiach Subsequent 30 Day Period (use reverse of, form for additional ceimments) I Comments SuperintendenUDesIgnate Signature Date cso 675?100 (10104) 13201:. I vim Ede? 000853 Page 2 Regional Director Review Continued Segregation Supported - El N01 Supported Comments irrqu v; gilt/j.? F0 2%?7 ?wzeL/ $791! ?(pr?W lis ch?? 7?2: [tau/ch4 ,am?J riff/b {bra-fut] Naylonal DjrectoriDesignate (Print) 1? {C/Mt/c/ Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date - DirectorIDesignate Date Continued/Additional Comments by SuperintendenUDesignate Comments Signature Date I I Clip?4? alt?? 'W?Vivrv' 7'34? f) (gr 4/ ?we Low-? aw tax/awI-r??t . I I i? I: ?Qk'jbi?lgt'v' LUC 9 CL *?(LU. :4012.x cuL I'eg?utueei Loni?(EL Rel-?Juu?ux {ant} . - . I. I 5i3?vt ?(0an dior??. Y- Lew-'1' ?IfAil?l??d (LID My} "(7:(1?5 Uri-k?? QW- 40? "blur-as 0 Site at?? at?1?ij (362(1- m't 5r~u?tl fu?mi??3rf?r? .Efz-voevgedr?td "1749 Continued/Additional Comments 9y Regional Director/Designed Comments Signature Date DIstdbutlon: Original - Regional Director (Only for Regional Director Review) Copy - Inmate File I WW) . CSD 075-100(10104) i NOV 3 2011. 000854 A m. . k_Segregation Decision/Review if Ontario - Institution North Bay Jail Name (Last. First. Middle) Client Identi?cation No. Reason(s) for Segregation Date of Segregation [2 Protective Custody El institution Security Medical Inmate Request 0712212014 inmate advised of reason for Segregation Inmate advised of opportunity to make oral or written Submissions Inmate advised of opponuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of SuperintendenUDesignate Date Jesse Webster, Security Manager NC)qu 0712312014 Superintendent Decision (T his section must be completed wimin 5 days of the inmate?s placement in segregation) Inmate Submission Superintendent Decision Release from Segregation [3 Continue Segregation Reasons: - Mental Heal?t Issues. Could not function on a living unit Administrative Hold for his own safety. Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date JesseWebster 0712312014 . vs. . Segregation Review (inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days} Inmate Submission Superintendent Decision Release from Segregation . >14 Continue Segregation Reasons: . - Administrative Hold due to Mental Health issues. Could not function on living unit Name of Superintendent/Designate (Print) Signature of Supermteademfgsignate Date Jesse Webster . 0712812014 Supplementary Report for each Subsequent 30 Day Period (usek?r/se arrorm foradditional comments) Comments SuperintendentlDesignate Signature MMblija?tfe [a ?err-r444;- r'4 5502/2/9/ . 680 075?100 (.10104) at . Qt) 1413 - ., .ee. _..eem i I s.21(1) 000855 Regional Director Review Page 2 Continued [Ii/Supported Not Supported Comments d5? 4% [Ma?a/?5 ?fe?61?. Name of Regional Director1Designate (Print) Signature of Regional DirectorIDesignate Leagues 2.2.1} Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Date I ?@7105; 2.17 Comments Signature Date ContinuedlAdditional Comments by Superintendent/Designate . Comments Signature Date Administrative Hold. Mental Health Issues. 1% 0810112014 Q. 1 Administrative Hold. Mental Health Issues. 0810612014 Administrative Hold. Mental Health Issues. 0811112014 1 - le' Administrative Hold. Mental Health Issues. 0811612014 - Qt . tit/i- - . Administrative Hold. Mental Health Issues. 0812112014 ?ll On th0&%- I M/{sufdc b?wfu/ aim 03/26/20:, 100M I . 03/01/2014: #4741191 Continued/Additional Comments by Regional DirectorlDesi nate Comments Signature Date Dlsu-lbutlon: Onginal - Regional Director (Only for Rwal Olmde mow: Copy - Inmato Flle CSD 075-1 00 (1 0104) 000856 ., 521(Segregation Decrsroanevrew Institution . - North Bay Jail Name (Last. First. Middle) Client Identi?cation No. Reason(s) for Segregation . Date of Segregation Protective Custody El Institution Security IE Medical Inmate Request - 08/17/2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions Inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for?interview with Superintendent - Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date JesseVWebster, Security Manager 08-18-2014 S_u_perintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission Superintendent Decision CI Release from Segregation Continue Segregation Reasons: Mental Health Issues. Name of Superintendent/Designate (Print) . Signature of SuperintendentlDesignate Date Jesse Webster "l LL - 08/18/2014 I Segregation Review (inmate's segregation to be reviewed every 5 days. Intervi?w with inmate to be conducted every 30 days) Inmate Submission Superintendent Decision Cl Release from Segregation lg Continue Segregation Reasons: :5 . Men rm. 55?" Name of SuperintendenUDesignate (Print) Signature of Superintendent/Designate Date Est; mess-w? @x?asiw gaze [20,35 Supplementary Report for each Subsequent 30 Day Period (use reverse ofform for additional comments) Comments Superintendent/Designate Signature Date "fc'nzl/ M41 CSD 075-100 (10/04) 000857 Page 2 Regional Director Review - Continued Segregation Supported Not Supported Comments . . Signature of Re inal Director/Designate Date Name of Regional DirectorlDesignate (Print) Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature . Date Continued/Additional Comments by Superintendent/Designate Comments Signature Date N/mumc L411ch (SSULSS. - L?x cw 1:505. - . 09/33/29,, 32.50255. (/03/23? WTAL wu?a?I I . I . Wit? [$301.55. - Oq lsgv??; . Continued/Additional Regional Director/Designate Comments - Signature Date Distribution: Original - Regional Director (Only for Regionat DirectOr Review) Copy - Inmate File CSD 075-100 (10/04) 000858 cy? Se ati i' ion/Revi I r) . greg ecs ew 5* Ontario Institution North Bay Jail Name (Last. First. Middle) Client Identi?cation NO. Reason(s) for Segregation I Date of Segregation Protective Custody Institution Security Medical Inmate Request 08/18/2014 'Inmate advised of reason for segregation Inmate advised of opportunity to make'oral or written submissions Inmate advised of opportuntiy for interview with Superintendent IE Inmate waives opportunityfor interview with Superintendent Name of SuperintendentlDesignate (Print) Signature of SuperintendegtlDesignate Date . Jesse Webster, Security Manager It 08-18-2014 SuperintendentrDecision (This section must be completed within 5 days of placement in segregation) Inmate Submission Inmate very uncooperative on admission and incoherent. I Superintendent Decision [3 Release from Segregation Continue Segregation Reasons: Inmate was assaultive on pick-up at Mental HealthCentre. Severe mental health issues. Could not function on a living unit, and will be segregated for his own safety and the safety of staff. Name of SuperintendenUDesignate (Print) Signature of Superintendent/Designate Date I Jesse Webster - 0811812014 Segregation Review (Inmate 's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) Inmate Submission . Superintendent Decision Release from Segregation Continue Segregation Reasons: Mad-m c, b?we?/ ?ves. - Name of Superintendent/Designate (Print) Signature of SuperintendentlDesignate Date. @555 0068923? 55?; - 45/25/29:: Supplementary Report for each Subsequent 30 Day Period (use rev 9 oftorm for additional comments) Comments . Superintendent/Designate Signature Date . 75 team for 3 face 7; ?69 i" SEP 2 Mint. CSD 075-100 (10/04) 521(1) 000859 Page 2 -: Regional Director Review Continued Segregation Supported Comments 75.5 $4?th Signature of Regional Director/Designate Name of Regional Director/Designate (Print) i x? :22. Zolii Not Supported Date av Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments Signature Date Continued/Additional Comments by Superintendent/Designate Signature Date Comments 4' fr?? 03/23/26: W054 Jane-14 A?s-gas. er" I. Minn-m? {Kau?S 09 113/70! I #4574on time? [Ssu?? f" 86? act/(311237; Lamb??/ [3305: 09/32/22: 1" Continued/Additional Comments by Regional Director/Designate Comments Signature Date Distribution: Original - Regional Director (Only for Regional Director Review) Copy - lnmale File CSD 075-100 (10/04) -- 000860 . Segregation Decision/Review Ontario - Institution North Bay Jail Fame (Last. First. Middle) Client identi?cation No. Reason(s) for Segregation Date of Segregation Protective Custody institution Security Medical inmate Request 08/22/2014 Inmate advised 'of reaSOn for segregation Inmate advised of opportunity to make oral or eritten submissiOns El Inmate advised of opportuntiy for interview with Superintendent inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date Jesse Webster, Security Manager 08-22-2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission Superintendent Decision El Release from Segregation IX Contintie Segregation Reasons: Having violent thoughts of harming other inmates. Administrative Hold. Name of Superintendent/Designate (Pririt) Signature of Superintendent/Designate Date JesseWebster Wg; .. - 08/22/2014 Segregation .Review (inmate's segregation to be reviewed every 5 days. interview with inmate to be conducted every 30 days) inmate Submission Superintendent Decision Release from Segregation Continue Segregation Reasons: Administrative Hold Signature of Superintendent/Designate Date ?Name of Superintendent/Designate (Print) Jesse Webster mp 08/27/2014 Supplementary Report for each Subsequent 30 Day Period (use reverse ofform ror additional comments) Comments SuperintendenUDesignate Signature Date Wd?Zf 575/ 555? 59W g4,- Amaze/W 7 6,91% 7' 030 075-100 (10/04) - SEP 2 521(1) 000861 Page 2 Regional Director Review Continued Segregation Supported [3 Not Supported Comments 5mm eta x? m? ?El A . Name of Regional DirectoriDesignate (Print) Signature of Regional Director/Designate Date A mar Do Lark-Q - 2'3: 7?Iy Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature Date Continued/Additional Comments by Superintendent/Designate - Comments . Signature Date f? - ark/mg! gal-4 u) .. I 09/6711/235} be? MB 09 1/11/23: Amaer NOLA. muggiffxw osprey/22:4 Ale/?J - 07/27? Continued/Additional Comments by Regional Director/Designate . Comments Signature Date - MM/dd/yny Distribution: Original - Regional Director (Only for Regional Director Review) Copy - inmate File 030 075-100 (10104) 000862 . a . .. a "r 7 Ministry of Community Safety gr 0 and Correctional Services 0 Institution Sudbury Jail Client Identi?cation No. Segregation Decision/Review Name (Last, First. Middle) Reason(s) for Segregation Date of Segregation Protective Custody Institution Security [3 Medical Request 10-28-2014 Inmate advised of reason for segregation Inmate advised of opportunity to make oral or written submissions i2! Inmate advised of opportuntiy for interview with SUperintendent Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signature of SuperintendenUDesignate Date Mr. Jeff Chambers 10-29-2014 Superintendent Decision (This section must be completed within 5 days of the inmate?s placement in segregation) Inmate Submission Own request, removed from unit for safety reasons. . Superintendent Decision Release from Segregation Continue Segregation Reasons: Own 30? Name of Superintendent/Designate (Print) 7 Signature of SuperintendentlDesignate Date ?02911 73' - u-ox) l?i Segregation Revie'w (inmate's segregation to be reviewed every 5 days. interview with inmJte to be conducted every 30 days) Inmate Submission Superintendent Decision Release from Segregation I Continue Segregation ReasonsDNA) 0 I Name of Superintendent/Designate (Print) . Signature of SuperintendentlDesignate Date I 1000:2501? Supplementary Report for each Subsequent 30 Day Period (use reverse of form for additional comments) Comments Superintendent/Designate Signature Date . DEC 0 i 2014 I 030 075-100 (10/04) 521(1) I (ii?A 000863 Regional Director Review Page" 2 I Continued Segregation K1 Supported 050 075-100 (10104) Copy - Inmate File ?x?3mments .3. m? we? 6/ yaw/?J Quit?lift {3 . r. Name of Regional DirectorlDesignate (Print) Sig . gignalp?iirecltor/Desrgn?ate ?Date . 1" . '7 . I irifia. i c/wJ (Mm/6 as m?v? .: I I 1 Supplementary Remrt for each Subsequent 30 Day Period (use-bottom of form for additional comments) Comments Signature Date Continued/Additional Comments by SuperintendentlDesignate CommeMs Sbn?um Dme ?ix FRI, Continued/Additional Comments by Regional Director/Designate Comments Signature Date a Distribution: Original - Regional Director (Only for Regional Director Review) 000864 . Segregation Decie i n! Revi aw . if Ontario . Institution Sudbury Jail Name First Middle) Client identi?cation No. to: Segregation . Protective Custody institution Security '3 Medical inmate Request 14?1 0430 Inmate ad?vieedof reason for segregation Inmate advised of opportunity?tc make oral ar?written Submissions 95] Inmate advised of opportuntiy for'inte'rviaw with Superintendent Name of Superintendentloesi'g'n'ate (P?nt) I Signature of?yz?ntendenUDe?s' ate Date Mike Ducharme? A 7 7_ it 2014-10?06 I section?must be completed wimInSdays of the inmate -'s placement in segregation) inadflfiew with Superintendent Superintendent Decision (This Inrn'ate submission Own protection Sup?fintenden? DeCiSion Release from-segregation If" Continue Segregation . ReasonsJuli-h: If" "a a? Name of Supeiintendent/Designate (Print) Signature of SuperintendentIDeSignate Date '-..- ..Q t; a, true; .1 Jinn Segregation REVIEW (inmate?s segregation to be reviewed every 5,days. interview with inmiare to be conducted every 30 days} Inmate Submission .. SuperintendentDecis'ion 1] Release fromgsebreiga?tion 7 ET - .Contmue?Segresatlon ReasonsName of Superintendent/Designate (Print) Signatui'e of'SuperintendegjiDe?siQnate Date . :1 5'ff?? :3 i' i ll Na (1:11.11 i. {ii?j. z- 13: v" . 5 Supplementary? Reportfor each Subsequent .30 Day Period, (useneverse of-fomrzfor addinpnaicommems). Cdmm'ents sup'enntenqentlDesignate Signature Date ?Leela/O I ?zglg ?3 N09 F) . llfui fun5-130 (10/ 4 14(2)(d) 7 0f: s. 19?- - 000865 Page 2 Regional Director Review Continued Segregation . J2: Stipported [3 NotSuEported Comments 'W?i (J A .f I ?Llfar/W -r'1 rm :Jfg of RegionalDirectorfDesignate (Print) I ,Sign?t'? OIRWEQQHBE Date i .-. . ?4 "we. (L, . (k {:17 w. 3' 1,1,Supplementary Report for each, Suosequent 30, Day-Period (use bottom of form ror additional commenssi ?Com'r'neh?ts' Signature Date 1 . "W?Qa?wfe?im ?41 Jul - o/ - an?? y/V?r 09?" . 26Continued/Additional Comments by SuperintendenUDesignate Cornments Signature Date Continued/Additional Comments by 'Regiori?l DireoiorlDeeignate. Comments Signature Date Dist?bu?cn: Origins! - Regional Director (Only for Regional Gimm'?'eview} Copy - Inmate File CSD 07540-3 (13:04; 000866 at}; i; Ministry of Community Safety . and Correctional Sewices 0" Ontario . Institution Sudbu'ry Jail Name (Last. First. Middle) .5, .. Segregation Decision/Review Client Identi?cation No. Reason(s) for Segregation El Protective Custody Institution Security Medical Inmate Request Datefo'r' Segregation 2014-1 1 ?04 Inmate advised of reason for segregation Inmate advised of?opportuntiy ?forinte?rview with Superintendent a Inmate advised of?opportunity to make oral or Written submissions Inmate?waives opportunity. for interview With Superintendent Name of Signature of i upei'intendentlD nate Date . - If 1 Mike Ducharme 2014-1104 i! w- Superintendent Decision (This section must be completed within 5 days of theinmete?s #f??ment i?rsegregation) Inmate Submission . Inmate is under suicide watch Superintendent Decis?ion? Release fromSegregation - 'Continue Segregation Reasons: g: "x L. ?val/k Name of Superintendent/Designate (Print) Signature of?SuperintendenUDesigJJ?ate Date [5 .x i i :at? r2320; 0/ 3 t) we tr Segregation Raviemi {inmate's segregation torbe reviewed even/.5 days. Interview with inmate to-be conducted even/?30 days) Inmate Submission Md tCki? A - i Superintendent Decision Ci ReIEasetrom Segregation ?Continue. Segregation Reasonsalt/K (M (?turn/M ?25 kw Name of Superintendent/De si nate (Print) Signature ofSuperintendenUDesignate- Date 4L in(3w emu< .O/Supplementaryjiie?port for each. Subsequent 30 Day Period. ?(use reverse offonni?or additional comments) Comments . ?Sup?rintendentlDesignate Signature Date . I 050 075-100 (1 0104) s.21(1) 000867 Regional Director Review Page 2 I Continued Segregation 43?, Supported Not Supported Frp?ents AL I Ia-?Nam egional Director/Designate (Print) f?RegionalDirector/Designate Date - - c/a w] C/Mw/cit. . MY Supplementary Report'for'each Subsequent 30 Day-Period (usebottom ofform for additional comments) Comments Signature Date Continued/Additional Comments by Superintendent/Designate Commems - SQnmUw Dme Continued/Additional Comments by Regional DireCtor/Des'igna'te Comments Signature Date Distribution: Original - Regional Director (Only for Regional Director Review) Copy - inmate File 050 075-100 (10104) 000868 . I In: -- I-u A nd?b? -- - Mi:th safety Segregation Decision/Review . an Drrec Una eerceS - if? Ontario . institution SUdbury Jail i Name (Last, First, Middle) Client Identi?cation No. Reasc?fs) for SegreQEtibn Date of Segregation 2014-09?30 Protective Custaay Security Memcal Inmate Request 7 Inmate advised of'reaeon for'segrega'iion inmate advised or?opportunity make oral 'or writzen submissions Inmate advnsed 01 foruntervnew With Superintendent Inmate waives mien/sew Supennrenden; Name 0fSuperintendent/Designate (Print) Signature gf?upWDesigr-wgt Date [It I (3/4 Blaine Lamothe 2014-10-01 . . Superintendent Decision {This sec?on'must be compfeied within 5 days 0%232?5 piecement in segregation) Inmate Subrnissioh I Own protection Superintendent Decision Release fror?ESegregation Continue Secregetion Reasons314-? if?: He; a Vb?: 31% 7 i Name of Superintende'ntIDesignete (Print) Signature of SuperintendentiDesigna?e Date -. .- - . . . . .- - - - i canbeg?7'Segregation Rewew ta be reviewed Every 5 days. Interview?with-mmare I0 be conducted every 30 days) I . lnmate-Smeission i . :1 {Hf?x, Jib": if". 791.;- Superintendent'Decision Release from Segregation Continua Sec-regain? Reasons.5. Name of SuperintendentJDesignate (Print) Signature ?ofSuperinzendent?De?signaie Dale ?mm saga-- ?tSulrzr3l~emen?taryI Repor: for each Subsequent-30 Day Penoa {use reverse offonm for Da - Su erintendentiDe?i ?n?te Signature 1? Comments - p- - 59 a - MMiddi?va Conan Newt/weed \1 (4-1 04' (/beQkQJ ?CSD 075?100 (ezd4(2)(d) DEC01 6:1 "a I C: eJ'??wJ 000869 jg}; Page 2 Regional Director Review Coniinued Segregation SUpported Not Supported CarnmentsVVMIS Q. .. a ?1 Ch" It?? W. 5X71 7k?) Lr? a N. All Name of Regional DirectoriD?esignate? (Prinz) i a A a ?14 nary k? DA luKG-A?u- 'crfSEsignaze ate fl W6 s! Supplementary Report for eachSubsequent 30 Day Period {use bottom offormlfor additional comment? Cdr?nme?nts Signa_!ure Date A @5629 cH?t 1? $3 I I liar/raw acNK?Ixxnv?g Cantinuec?IAdditionaE Comments by Superintendentl?esignate Signature Date I ContinuedlAdditionai Comments by Regional DirectorfDesignate C?mments Signature Date Distribution: edginal - Regional fa! Ccpy - Inmate Fla I 000870 I Segregation Decision/Review Ontario Institution Sudbury Jail Client Identi?cation No. Name (Last. First, Middle) - Reason(s) for Segregation . Date of Segregation El Protective Custody Institution Security Medical Inmate Request 08/169014 - . . Inmate advnsed of reason for segregation Inmate advised of opportunity to make oral or written submissions inmate advised of opportuntiy for interview with Superintendent Inmate waives opportunity for interview with Superintendent Name of Supenntendenti'Designate (Print) SignatureofSuperin nden rignate Date Jeff Chambers 7&3- . 08/1si2014 Supenntendent Decismn (This section must be completed within 5 days ofthe inmate's Inmate Submission NIA placement in segregation) Superintendent Decision El Release from Segregation #2 Continue Segregation Reasons: inmate has a broken jaw. Name of SuperintendenUDesignate (Print) Signature14 Confmue Searecz?on . - Suicide watch Name 3f sm?iawmgm (Print) 1 Sigma of Wd??baignae Date Dechsz. . - 53/7/15; 021312014 Sunplementary Report for each Subsequent 30 Day Period (use reverse olfanw com) I Come?ms Slzperinbenden?besigm'e Signature Bat; . Attempted suicide placed on constant watch 022012014. Inmate assessed and continues on suicide watch . {Ema/2?Inmate. con?nues on suicide watch - ammo? ,9 5 3 csoo75-1oo more02:01.; ,6 (Jo-,7 . I . I x?j??yf - h) ?-Dam/ PS gaff".- .i are?? rP-sulclx .Ett-L/tQ? . . lo [124; Continued/Additional Comments by District Administrator/Designate elk?lust. W031 us it; (1.4- - Signature a?ont 0T at Mae ,5th Date mac-?y Distribution: Original - District Administrator (Only lor District Administrator Review}; Copy - Inmate File 1 000944 .i .. . )r . if Ontario Segregation Decision/ReView Institution 7 MAPLEHURST CORRECTIONAL COMPLEX Name (Last. First, Middle) Client Identification No. FHeason(s) for Segregation Date of Segregation - Protective Custody IE institution Security El Medical inmate Request .. . inmate advised of reason for segregation inmate advised of opportuntiyfor interview with Superintendent inmate advised of opportunity to make oral or Written submissions Inmate waives opportunity for interview with Superintendent Name of Superintendent/Designate (Print) Signasyge of Superintendent/Designate Date l' f" Superintendent Decision (This section must be completed within 5 Inmate Submission placementme?ggion) 446 Amaze-- - Superintendent Decision Release'trom Segregation El Continue Segregation '3 Reasons: eemeg? ([4102, Name of Superintendent/Designate (Print) TbiltabA Signature of Superintendent/Designate 7 Date Segregation Review (Inmate's segegation to be reviewed every 5 days. lntervlew?ith marge to be conducted every 30 days) inmate Submission [fl/L El Superintendent Decision Release from Segregation Reasons: Continue Segregation meg L, 90:; . Date Name of SuperintendentlDesignate (Print) - I Signature oi SuperintendentlDesignate ?u {la/e4 Supplementary Report for each Subserment 30 Deg Period (use reversed form for additionaimgnmenrs) Comments Superintendent/Desig ate Signature Date Day I Month I Year 1? I H- a I: . dk?LfQu??j (waf?e-4?5 ?re/31f . 015?: ?13? Ma g??l?gme belle/3914 sl?inn?n? .J .- cougar?- ?i521(1) .. . CSD 075?100 (rev. 03/2011) 000945 a. 3 Regional Director Review Continued Segregation Not Supported Comments 7 lia/ Supported I Name of RegionaWXE?j'tb? Signature/Wt (?arr/4y Supplementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments Comments Signature I Daria, ay ont ear ContinuedlAdditional Comments by Superintendent/Designate Comments Signature-?3 . Date Day/ Month!r Year - I I My ?1an ML . Mot Smemi 5 f. Same oecs/ 20/4 l/ "a log lei [Ly- ?rJf/Ql?r 7? . Q?h "~91qu CLAJL 02.4% Lat <9 >491, @a f/ 3Ja?l4t H75 {agave}; 65.395?- PS act/m1 Continued/Additional Comments by Regional Director/Desig .i?gnature it: - Date Day Month lYear Comments 'Jgj74//?i Qomc/L??" H091 ?anker? 842A hUA?r j?/ISf/j?f/ :4 rake/1%? 0?5 (Sgt ?Ceyme 13/6/17} . I I . . ?aw/W .1/7 5?0 - eoLS a ?ew-5: - 6150 075-100 (rev. 03/2011) - Iva! 9? in 117' fin/If gel/row ?liale I f?f Al/?Ia/tll 000946 it. i Distriot Administrator Review Continued Segregation Supported . Not Supported Comments Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date Slippiementary Report for each Subsequent 30 Day Period (use bottom of form for additional comments) Comments I Signature Date Continued/Additional Comments by Superintendent/Designete - Comments Signature Date 7 ?ow/x7 - 4/4 I I I 1760 write/{we 09 not i I 2N6 mi? ContinUed/Additionai' Comments by District Administrator/Designate Comments Signature Date Distribution: Original - District Administrator (Oniy for District Administrator Review) Copy - Inmate File 000947 . 0" Ontario Services Ministry of Community Safety and Correctional Segregation Decision/Review institution Maplehurst Correctional Complex Re?ason(s) tor Segregation Name (Last. First. Middle) I 1 Client identification No. Date of egr7ation Protective Custody institution Security Medical D'lnmate Request advised of reason for segregation inmate advised oi opportuntiy lor interview with Superintendent p6 10 a let Mate advised of opportunity to make oral or written submissions inmate waives opportunity tor intenriew with Superintendent Signature 3 rintendenllDesignate Date Name of Superintendent/Dmt) bee?ng Superintendent (This section must be completed witnin 5 days of the inmate?s placement in segregation) inmate Submission Ci Superintendent Decision Release from Segregation Bf Continue Segregation Reasons: tit/105MB? Name oi Superintendent/Designate (Print) Date Signature olSuperintendent/D nate R050 germ-e Soar - -i Segregation Review (Inmate's segregation to be reviewed every 5 days. Interview with inmate to be conducted every 30 days) inmate Submission ,4/0 r" 7' I Cl Superintendent Decision Continue Segregation Reasons: I Release from Segregation Name of Superintendent/Designate (Print) Signature of Superintendent/Designate Date - Supplementary for. each Subsequent 30 Day Period (use reverse of ferqy?for additibnalcoi'nments) Comments - Date A He; 1M Superintendent/Designate 'r ature lam/iv] 521(1) 000948 District Administrator Review Continued Semegation Supported Not Supported Comments Name of District Administrator/Designate (Print) Signature of District Administrator/Designate Date Supplementary Report for each Subsequ ent 30 Day Period (use'bottom of form for additional comments) Comments - Signature - Date Continued/Additional Comments ngLperintendent/Designate Comments Signature Date. . . MM/dd/mr mom/KM/Cq" - A: p52 tub 2M 244?51ck?'??59 QQE - [Obelii +0 ?say-2/71!? (WV fugue Mmiiwb-fro a Noi/ ?f 4364/?? 3-on Mow If/f?d a {Sf/$1 (A53If. Ln:p Oil/(K. i [137% Continued/Additional Commetits by District AdministratOr/Designate . Comr'nents\ Signature Date . it "e2: e1 ?r - Distribution: Originai - District Administratm (Only for District Administrator Review) Copy - InmateI File 000949 0 Regional Director Review Continued segregation Supponed Comments ID Not Supported Name of Regional Director/Designate (Print) Signature of Regional Director/Designate . Date Supplementary Report for each Subsequent 30 Day Period (use bottom-of form for additional comments Comments Signature Date Day I Month I Year Continued/Additional Comments by Superintendent/Desig?te - Comments - . ignature Date a - Day I Month I Year Fri/C"? (kl??Delia cm. Mg??i?ki0co& a I (Sf Ago/M 0771/5 421 Keel . fix/0. 32/125 i #9 '2a/r3/f I ?5 {strip-A ?ai- deide r; ?WD?f?l/tc; ,j?g?mj, ?7/2 (HS - Continued/Additional Comments bLRegional Director/Designate Comments Signature Date Day I Month I Year 521(1) senate Distribution: Original - Regional Director [Only for Regional D'rector Review) Copy - Inmate File 080 075-100 (rams/2011) Regi?nr'etl Drir-iji 000950 Segregation Decrsron/Revrew Institution . MAPLEHURST CORRECTIONAL COMPLEX Name (Last. First. Middle) Client Identification.No. I Reason(s) for Segregation - Date of Segregation .I ?1 I ?quill; J- Protective Custody institution Security [3 Medical inmate Request . .g .r L?iinmate advised of reason for segregation Inmate advised of opportunity to make-oral or written submissions Dinmate advised of opportuntiy for interview with Superintendent ?inmate waives opponunity for interview with Superintendent Name of Superintendent/Designate (Print) ("Signature of Superintendent/Designate Date Superintendent Decision This section must be compieted within 5 days of the inmate's piacement in segregation) Inmate Submission - . . 444; gr? hair/Wt fj??f/?i Superintendent Decision Release from Segregation - Continue Segregation Reasons: I - as A, Macaw/- 4? Name of Superintendent/Designate (Print) Signature of superfmte'hdentlDesignate Date If - I I, ?i ,1 rji?ia??iffii - . {41; 24/571 - - . Segregation Revrew (Inmate?s segregation to be reviewed every 5 days. inmate to be conducted every 30 days) inmate Submission 7 . 27.6; k\ S?erintendent Decision [1 Release from Segregation Continue Segregation Reasons: A I. Let 1/ Name of Superintendent/Designate (Print) Signatureof SuperintendentiDesignate Date gauze?) (Lexi . 5? At mt- S_ugplementary Re?on for each Subsequent 30 Day Period (use reverse of form for . . Comments Superintendent/Designate Signature Date - KN Dayl Month I Year . .xvi-71f ?r "Jae-"1 . . Obj?.9 rmjil?Cr-igi n.th F?i "Wiltif}! a. -7 1rHat?? 94.? - A CSD 075-100 (rev. 03/2011) 000951 1 Regional Director Review Continued Segregation Supported Not Supported Comments Name of Regional Director/Designate (Print) Signature of Regional Director/Designate Date Supplementary Report for each Subsequent 80 Day Period (use bottom of form for additional comments) Comments Signature Date Day Month I Year Continued/Additional Comments by Superintendent/Designate TN Comments Signature Date Ext-'1. . Day/Month Year 14/ rbrlizx. 057 4.99:5 air-tit - {620'? Y?Lao?thVL-x 10?0?1 Maser . I I I . I HDir;,1 ert? a? r-x 01? {Sh-fink. '7 . . g?ggff?/gs/ "7 1' . 1 41/15 (SL4. fr 3:4 be! ?eioz/wm . 7 [/20 :D'kjhr?? I Ail Jr?- - . . I?mu. I .7 .9. by Regional Director/DeSIgna Sir?Jr'- r/ff? - Comments ?Signature Date . Day Month Year . - . ?16, r: I l/?r f/l if if)? attirj?ll I?l/i/ L4, . . - ,amtaumv {riff?EJJiQKD?i??E/rfg?ewew) . Wm - i . Off/0 9?5 521(1) 7 a: - aw? - 5.2mm) '3 (:30 075-100 (rev. 03/2011) Ilii? - 1?03000952 a? an a. . District Administrator Review Continued Segregation [3 Comments Supponed- . Not Supported Name of District Administrator/Designate (Print) Signature of District AdministrEtor/Designate Date Period (use bottom of form for additional comments) Supplementary Report for each subsequent 30 Day, Comments Signature Date Continued/Additional Comments by Superintendent/Designate Comments - Signature Date - ?rm? 0A) 5% #Av?t/ . ?Air/r4 Or?x {By} 5 ?g ti ri?e/10H we: at i am. mix emu. ,1 .WKA- Macaw A A I'o?th?gich i MW - 3L Loin hd Cr 4-1 Lev-nit" .4 lira?w?Ot?i IL.ng +0 rCi'urr?i b?HamrH?On? try-\uxt( ML (if?la 4pr?m? :1 K/d'm Conti??ed/Additional Comments by? District Administra 'ae a Comments Signature Date 521(1) 04 3-5 I Original - District Administrator (Only for District Administrator Review) Copy - Inmate File 000953 . I 7 s.21(1) - I s. Regional 30 Day Segregation Report 2 Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar Note: if the inmate has not reached the 30 continuous days in the month identified, it will carried over into tl 30 continuous days in segregation inmate is admitted to segregation on September 5th will be captun Maplehurst Correctional Complex Oct?01?14 Maplehurst Correctional I Complex - May-0144 Maplehurst Correctional Complex Sep~02?14 Maplehurst Correctional Complex Aug-0644 Maplehurst Correctional - Complex Mar-26-14 Maplehurst Correctional 7_ Complex 7- I Sep?18-14 Maplehurst Correctional Complex 7 . Jul-29914" Maplehurst Correctional '0 Complex I - Nde04-14 Maplehurst Correctional I Complex Nov-O7-14 000954 month. he next reporting month once they have reached the ed in the October report if more than 30 continuous days). To protect the security of the institution or the safety of other inmates Inmate requests to be placed in segregation Inmate is in need of protection Inmate requests to be placed in segregation Inmate is in need of protection. Inmate is in need of protection - Inmate is in need of protection Inmate is in need of protection 7 Inmate is in need of protection 000955 issues Refusing treatment by Mental health issues No Will not go to=a unit PC I Will not go to a unit PC Will not go to a unit GP Yes Heinous Crime Transfer to another-facility will not 30 to a unit Transferto another facility - issues seen by Health Care issues seen by Health Care Mental healthissues Yes issues seen by Health Care . Mental health issues Yes snzuzxd) sa21(1l 000956 1? Complex Double click to pick date Maplehurst Correctional - Complex May-01?14 Maplehurst Correctional I Complex - - Se'p-02-14 Maplehurst Correctional - Complex Aug-06-14 Maplehurst Correctional Complex . Mar-26-14 Maplehurst Correctional I 1 Complex - Sep-18-14 Maplehurst Correctional I Complex - . Jul-29-14 Maplehurst Correctional Complex . Regional 30-Day Segregation Report 7 Report details consists 0f inmates admitted to segregation for a period of 30 continuous days in a calendar Note: If the inmate has not reached the 30 continuous?days in the month identified, it will carried over into tI 30_contianUS days in segregation Inmate is admitted to segregation on September 5th will be captun Maplehurst Corr i" ?4 L. ection?al Maplehurst Correctional Complex Oct 10-2014 521(1) 000957 month. he next reporting month once they have reached the ad in the October report if more than 30 continuous days). Inmate requests to be placed in segregation Inmate is in need of protection inmate requests to be placed in segregation Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection Inmate-is in need of protection 000958 .Will not go to a unit PC . Will not go to a unit PC Will not go to a unit GP Yes Heinous Crime Transfer to another facility -will not go to a unit Transfer to another facility issues Yes Suicide watch seen by Health Care seen by Health Care Yes issues seen by Health Care Yes 521(1) I 000959 Maplehurst Correctional Complex NOV-02-2014 - Maplehurst Correctional Complex 14 Maplehurst Correctional Complex Dec-01-14 Maplehurst Correttional Complex Double click to pick date Maplehurst Correctional Complex Nov-12-2014 Maplehurst Correctional Complex N0v?12-2014 Maplehurst Correctional Complex Jan-28-2014? Maplehurst Correctional - Complex Sept 30-2014 Maplehurst Correctional Complex Sep-O4-l4 Maplehurst Correctional Complex Sep?24-14 sAzuzxd) ic21u) s;21(2xr) 000960 To protect the security of the institution or the safety of other inmates To protect the security of the institution or the safety of other inmates To protect the security of the institution or the safety of other inmates Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection Inmate is in need of protection 000961 Psy'Chiatric issues seen by Health Care Yes issues seen by Health Care Yes seen Health Care Yes Medical Observation/Immigration Hold seen by Health Care Medical Observation seen by Health Care Yes Medical Observation seen by Health Care Yes . Medical Observation seen by Health \Care Yes Medical ObservatiOn seen by Health Care Medical Observation seen by Health Care 000962 r. . Ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year 2AE Central Region Toronto East Detention Centre Aug 2014 Name (Last First, Middle) Date Segregated Segregation Approve], Continuing Segregation Reason for continumg Continuing Segregation . . (mm/dd? Institutional Approval Segregation Reglonal Approval Client Identi?cation No. 05-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated at YES NO . Insmu?onal Security Other. his own request. Calin?is' to fear - sadely on the regular Date Released: units. - 29-Nov-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 208 - Signature 03-Jan-14 'Reason for Current Segregation: Select length of time: 30 Days Reason: Own request- Fears for his YES No Own Request Other safety on all units 7 Date Released: Review Completed 0n: . 09-Aug-14 Approved By: HOWES. Robert To'tal of Days in Seg: Title: Sergeant Signature 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: High Pro?le Case? Own YES NO I I Institutional Securit Reque? t? remain in . Other: segregation. Fears for his s.21(1) Date Released: safety Review Completed On: - 09-Aug-14 Approved By: HOWES. Robert Total #Iof Days in Seg: Title: Sergeant - Signature ate Report Summary Printed: 000963 Page 1 of 1- .Py? I Ontario I 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year 2AE Central Region Toronto East Detention Centre Aug 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Segregatm" Reason for copt'nu'ng commimg Segregat'on Institutional Approval Segregation Regional Approval Client Identi?cation No. m? 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains segregation due to YES, NO . . . institutional security? Please Institutional Security Other: see 5 day review reports Date Released: 20-Aug-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Sag: Title: Sergeant 49 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Continue with current YES No Own Re ?est segregation plan. High Pro?le 7 Other: Case- Date Released: Review Completed On: 09-Aug-14 Approved By: HOWES. Robert Total of Days in Segz. Title: Sergeant - Signature 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains segregated at YES NC El Misconduct (Pendin Ad'udication) ?wn request Cla'ms that he 1 Other: tears safety. s.21(1) Date Released: 06-Dec-14 Review Completed On: . 20-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 171 ., Signature Page 2 of 1 ate Report Summary Printed: 000964 a f?v- VPOntario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year late Report Summary Printed: 2AE Central Region Toronto East Detention Centre Aug 2014 . Name (Last. First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuung Continuing Segregation I (m-mfdd, . Institutional Approval Segregation Regional Approval Client Identi?cation No. WW . 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate states that he fears his No I: . . . safety and remians in Misconduct (Pending Adjudication) Other: segregation at his own request Date Released: 11-Dec-14 Review Completed On: 20-Aug-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 176 7 . Signature 21-Mar-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated at YES NO - Own Request Other: his own request. 4 . . Date Released: 27?Aug-14 Review Completed On: 20-Aug-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 159 Signature 26-Feb-14 Reason lfor Current Segregation: Select length of time: 30 Days Reason: Segregated on Inmate's own YES No Inmate is in need of Protection Other: 7 request I 321 (1) Date Released: 09-Aug?14 Review Completed On: 01-Aug-14 Approved By: HOWES, Robert Total oiDays in Seg: - Title: Sergeant 164 I Signature .000965 Page 3 of obv? DPOntario 30?Day Segregation Report Summary i ZAW Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 Name (Last. First Middle.) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation - - - Institutional Approval Segregation Regional Approval Client Identi?cation No. my . 18-Jun-14 - Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains In segregation YES [3 NO - - - because inmate is having Inmate is in need of Protection Other: dif?cumy getting along with me Date Released: I other inmate. 28-Nov-14 Review Completed On: 20-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: ?Sergeant 163 Signature 22-Jun-14 Reason for Current Segregation: Select Ie'ngth oftime: 30 Days Reason: Inmate is segregated because [1 NO [3 . he is possible "Special Needs" Inmate Is in need of Protection Other: and is unable to funcuon on a Date Released: - - regular living unit- 16-Oct-14 Review Completed On: 21?Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant - 116 Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains in segregation on YES No Medical request of Medical Unit. s.21(1) Madlcal Observations Date Released: 12-Sep-14 Review Completed 0n: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 72 - Signature 000966 Page 4 of ate Report Summary Printed: 30 Day Segregation Report Summary r~ 5 tr? . Ontario Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 . Name (La'stl First] Middle) - Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation I Md, institutional Approval Segregation Regional Approval Client identi?cation No. mm 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains segregated for N0 Medical medical observation. Inmate . Other: has a cast on foot. Date Released: 12-Sep-14 Review Completed 0n: 28-Aug?14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 72 Signature 04-Jul-1-4 Reason for Current Segregation": Select length of time: 30 Days Reason: Inmate is segregated on admin YES [3 No Misconduct (Pending Adjudication) om?r: ?9 as 99' Sawmi- -Date Released: 16-Aug-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 43- Signature 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains segregated YES [3 N0 Medical - because he requires a medical Other: walker. 5.21 (1 Date Released: 27-Aug-14 Review Completed 0n: 20-Aug-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 70 Signature Page 5 0 ate Report Summary Printed: 000967 y. . 3- Ontario 30 Day Segregation Report Summary Month Ending I Year 20 Region Institution Name: Central Region Toronto East Detention Centre Aug 2014 Name (Last. First, Middle) Date Segregated Segregation Approval coqt'ny'ng segregat'on Reason for coptmumg segregat'on I . 7 Institutional Approval Segregation Regional Approval Client Identi?cation No. WW - 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains in segregation due his aggressive behaviour Misconduct (Pending Adjudication) Other: towards staff and other inmates Date Released: 24-Sep-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 84 Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Continues to be in segregation YES NO Medical 0th on medical observation er: Date Released: - 15-Aug-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 44 Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Serving misconduct for YES refusing to transfer out. Misconduct (Pending Adjudication) omen. Inma?e Wm not go to any Omar s.21(1) Date Released: institution 06-Aug-14 Review Completed 0n: - 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 35 . Signature late Report Summary Printed: Page 6 of 1 000968 y; . . Ontario 30 Day Segregation Report Summary ZC Region Central Region institution Name: Toronto East Detention Centre Aug 2014 Month Ending I Year Continuing Segregation Reason for continuing Continuing Segregation Name Last, irst. Middle Date Se re ated Se re ation A roval . . . . A I . (mm/dd, )9 9 pp Instituttonal Approval Segregation Regional Approval Client Identi?cation No. 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is special needs and YES No - - - cannot function on a regular inmate lS tn need of Protection omen Inmate ?mg unit Date Released: I 09-Oct-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 99 Signature 02-Jul?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate continues to remain YES segregated because of Misconduct (Pend'ng AdJUd'cahon) Other: behaviour. Several outstanding Date Released: criminal charges of threaten death towards staff. Review Completed 0n: 28-Aug-14 Approved By: Jamie Total of Days in Seg: Title: Sergeant 84 Signature 29?Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is "Special Needs" and YES NO Medical 7 is unable to function on a Other: regular living unit at this time. 521(1) Date Released: 02-Oct-14 Review Completed On: 28-Aug-14 Approved By: Jamie Total of Days in Seg: Title: Sergeant 65 . Signature late Report Summary Printed: Page 7 of ?000969 30-Da Se re ation Re ort Summai: . 9 Ontario 2C Month Ending I Year Aug 2014 Institution Name: Region Toronto East Detention Centre Central Region Name (Last. First. Middle) Date Segregated - Segregation Approval Reas??ggtg (3:3?an Client identi?cation No. (mm?dd?ym) 9 21-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated for YES NO Medical . medical observation. Other: Date Released: 12-Sep-14 Review Completed 0n: 20-Aug-14 Approved By: PERKINS. Jamie Total 01 Days in Seg: Title: Sergeant 53 Signature 09-Sep-13 . Reason for Current Segregation: Select length of time: 30. Days Reason: Medical Observation- YES NO MedicaI Requires medical equipment Other: that cannot be placed on a unit Date Released: 20-Aug-14 Review Completed On: . 09-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 345 Signature 25-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: YES NO own Request unable to live on a normal Other: inmate living unit s.21(1) Date Released: 16-Oct-14 Review Completed On: . 25-Aug-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 325 . Signature Page 8 of 000970 late Report Summary Printed: .Py} 0" Ontario '30 Day Segregation Report lSUmmarV Region Institution Name: Month Ending I Year 50E . Central Region Toronto East Detention Centre Aug 2014 - - Name (Last, First, Middle) Date Segregated Segregation Approval Coqt'npmg segregat'on Reason for copt'numg commg'ng segregatlon . . . (mm/dd?, Institutional Approval Segregation Regional Approval Client Identi?cation No. 1 WV - . 02-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is special needs and - NC A . . . cannot function on a regular Inmate ism need of Protection Other: living unit Date Released: 14-Nov-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 196 Signature I 30-May-14 Reason for current Segregation: Select length of time: 30 Days Reason: Inmate is special needs and YES NO Medical - cannot fuction on any other Other: living unit Date Released: 12-Sep-14 Review Completed on: - . 01-Aug-14 Approved By: HOWES. Robert Total of Days In Seg: Title: Sergeant 105 Signature 04-Jul-14 Reason for Current Segregation: Select length of time: 30 Days. Reason: inmate is segregated because YES No Inmate is in need of Protection Other. he '3 Speda' Needs and '5 - unable to function on a regular 5 21(1) Date Released: living unit. 08-Oct-14 . - Review Completed 0n: I 05-Aug-14 . Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 95 - Signature - late Report Summary Printed: Page 9 of 000971 Va A 30 Day Segregation Report Summary . . Ontario SCE Month Ending I Year ?Aug 2014 Institution Name: Region Toronto East Detention Centre Central Region ate Report Summary Printed: Name (Last. First, Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation - - Institutional Approval Segregation Regional Approval Client Identi?cation No. WW - . 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is Special Needs. YES NO Own Request - Inmate can not function on Other: regular unit at this time Date Released: - Review Completed On: 14-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 04-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated because "special Needs" and Is - Inmate is in need of Protection omen unable {9 function on a regular Date Released: -ivlng unit. 12-Aug-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 69 Signature - 08-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate ln?sonsldered as YE NO Inmate is in need of Protection Olher. Spec!? News and ?3 s.21(1) - function on a regularinmate 21 2 Date Released: living unit at this time. 5- . 12-Aug-14 Review Completed On: 07-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 35 Signature Page 10 of 000972 . y; Ef-POntario Month Ending I Year 30 Day Segregation Report Summary Region Institution Name: Central Region Toronto East Detention Centre Aug 2014 Name (Last, First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . I Institutional Approval Segregation Regional Approval Client Identi?cation No. my 27-Apr-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is considered SNU and YES No . . . unable to function on a re ular inmate Is In need of Protection Other: unit 9 Date Released: 12-Sep-14 Review Completed On: 25-Aug?14 . Approved By: - HOWES. Robert Total of Days in Seg: Title: Sergeant. 138 - I Signature 10-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Special Needs tnmate- YES NO Inmate is in need of Protection Other. can?! 3 . un? Date Released: 20-Aug-14 Review Completed On: 09-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Titte: Sergeant 71 Signature 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate fears all units and YES NO Inmate is in need of Protection omen ?Shes ?3 rema?" segrega?m" . - 521(1) Date Released: 'Review' Completed On: . 09-Aug-14 Approved By: HOWES, Robert Total of Days in Seg: . Title: Sergeant Signature Paget1 oft ate Report Summary Printed: 000973 v? 30 Day Segregation Report Summary 5CE Region Central Region Institution Name: Toronto East Detention Centre Aug 2014 Month Ending I Year Name (Last, irst. Middle) Date Segregated Segregation Approval ?ggm?agliepggfoggrn c?gg?umg - a Client Identi?cation No. (mm?dd?ywy) 9 pp 30-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is Needs" and YES NO Special Needs is unable to function on a Other: regular living unit. Date Released: 12-Sep-14 Review Completed On: 28-Aug-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 105 . Signature 24-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES N0 [1 Own Request own request claims to fear Other: safely on all units. Date Released: Review Completed On: . 21-Aug?14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 22-Jul-14 Reason for Current Segregation: Select length oi time: 30 Days Reason: Inmate remains segregated YES I: NO Medical because he is possible 5 21(1) Other: ?Special Needs" and is unable I Date Rereased; to function on a regular living 04-Nov-14 Review Completed On: 21?Aug-14 Approved By: PERKINS. Jamie . Total of Days in Seg: I Title: Sergeant I 1057 Signature rate Report Summary Printed: Page 12 of 000974 n1) . Ontario 5C5 Region . Central Region Institution Name: Toronto East Detention Centre Month Ending I Year Aug 2014 . 30 Day Segregation Report Summary Name (Last. First. Middle) Client Identi?cation No. Continuing Segregation Reason for continuing Continuing Segregation Iate Report Summary Printed: Date Segregated Segregation Approval . . . . Institutional Approval Segregation Regional Approval 23-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated because YES N0 di al he is previous "Special Needs" . Other: and is unable to function?on a Date Released; regular living unit. 13-Sep-14 Review Completed On: . 22-Aug-14 Approved By: PERKINS, Jamie - Total #of Days in Seg: Title: Sergeant 52 Signature 30-May-14 I Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated because YES NO Medical he Is "Special Needs" Other: and Is unable to function on a Date Released: regular livlng unit. - 09?Dec-14 Review Completed On: - 28-Aug-14 Approved By: Jamie Total of Days in Bag: I Title: Sergeant 193 Signature 02-May-14 Reason for Current Segregation: Setect length of time: 30 Days Reason: Inmate is "Special'Needsunable to function on a Inmate is in need of Protection Other: regular ?wing unit. s.21(1) Date Released: 14-Nov-14 Review Completed On: - 28-Aug-14 Approved By: . PERKINS. Jamie . Total of Days In Seg: Title: Sergeant 196 Sig nature - Page 13 of 1000975 30 Day Segregation Report Summary (1 . . Ontario 505 Region Institution Name: I Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 Continuing Segregation Continuing Segregation Reason for continuing Name Last. First, Middle Date Se ire ated Se re ation A roval . . . . . i )9 9 pp Institutional Approval Segregation Regional Approval, Client Identi?cation No. WW 31-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains to be No . . . segregated at his own request. Inmate '5 need 0f Pmtecuon Other: Inmate is unable to function on Date Released: a regular living unit. 20-Sep-14 Review Completed On: - 28-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 51 Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is very unpredictable YES N0 [1 Inmate is in need of Protection and is segregamd Other: because of previous 5-21 (1) Date Reieased; . Institutional behaviour. 09-Oct-14 Review Completed On: 28-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 99 . Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES NO - - - - Needs" and is unable to Inmate IS need Of Prqtecuon Other: function on a regular living unit. Date Released: Review Completed On: 28-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant - Signature Page 14 0 ate Report Summary Printed: f1000976 Cir? 30 Day Segregation Report Summary - Ontario 5cw Region Institution Name: Month Ending [Year Central Region Toronto East Detention Centre Aug 2014 Name (Last, First. Middle) Date Segregated Segregation Approval coqt'nymg segregation Reason for commiung segregatl'on (mm/dd/my) Institutional Approval Segregation Regional Approva Client Identi?cation No. - . 02?Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate?is Splecial Needs and YES {3 N0 - - - cannot unct on on a regu ar Inmate is in need of Fl?rotection omen inmate living unit Date Released: Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant - . Signature 29-May-14 Reason for Current Segregationr Select length of time: 30 Days ReaSon: inmate is Special needs and YES NO Medical cannot function on a regular Other: unit Date Released: 09-Nov-14 Review Completed 0n: . 01-Aug-14 Approved By: HOWES. Robert Totai of Days in $99: Title: Sergeant 164 . Signature 30-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Segregated on inmates own YES No - request . - - Medical Olher; Date Released: 09-Dec-14 Review Completed On: . 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 193 Signature late Report Summary Printed: Page 15 of ?000977 30 Day Segregation Report Summary r~ . [Eff?)Ontario 5cw Region Institution Name: Month Ending I Year Central Region Teronto East Detention Centre Aug 2014 Name (Last First, Middle) Date Segregated Segregation Approval Continuing Segregation 'Reason fer continuing Continuing Segregation I Institutional Approval Segregation Regional Approval - Client Identi?cation No. WW . 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO El . . . becau5e he threatens to Inmate '5 need Of Pmtecuon Other: assault other inmates. Inmate - Date Released: Is not able to function on a 14_Nov_14 regular living unit. Review Completed On: 13-Aug-14 Approved By: PERKINS. Jamie Total 1: of Days in Seg: Title: Sergeant 364 Signature 25?Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed special YES N0 Inmate is in need of Protection . need? and '5 ?name Other. function on a regular inmate Date Released: living unit 23-Sep-14 Review Completed On: I 24-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 60 . Signature 03-Feb-t4 Reason for Current Segregation: Select length of time: 30 Days Reason: Unpredicabie behaviour. YES No - - - Unable to placa on a regular Institutional Security Other: unit. Date Released: s.21(1) 01-Oct-14 Review Completed On: 09-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 249 A - Signature Page 16 of 000978 iate Report Summary Printed: 30 Day Segregation Report Summary Ontario Region Institution Name: Month Ending I Year iate Report Summary Printed: Date Released: 12-Sep-14 Review Completed On: Inmate is in need of Protection Approved By: Other: Total of Days In Seg: is unable to function on a regular living unit. 5CW I Central Region Toronto East Detention Centre Aug 2014 Name (Last First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation - (mm/dd! Institutional Approval Segregation Regional Approval Client Identification No. - WW - . 05-Jul-14 Reason for Current Segregation: Select length of time: -30 Days Reason: inmate remains segregated YES No . - - - because he is."5peclal Needs" Inmate is in need of Protection omen and is unable to function on a Date Released; regular living unit. 12-Aug-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 38 Signature 20-Apr-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needs" and YES No 7. 20-Aug-14 PERKINS, Jamie Title: Sergeant 1?45 Signature 29-May-14 Reason for Current Segregation: Select length oftime: 30 Days Reason: inmate Is possible "Special YES NO I Medical - Needs" and is unable to 5 21(1) - Other: function on a regularli'ving unit. Date Released: - 09-Nov-14 Review Completed 0n: 28-Aug-14 Approved By: PERKINS. Jamie - Total of Days In Seg: Title: Sergeant 164 I Signature Page 17 of 000979 30 Day Segregation Report Summary -. - . Ontario 5cw Region institution Name: Month Ending I Year Central Region Toronto East Detention Centre AUQ 2014 - - - Continuing Segregation Reason for continuing - Continuing Segregation Name Last. Firstatlon A roval . . . . I dd e) (mrniddeg gate 9 - pp Institutional Approval Segregation . Regional Approval Client Identi?cation No. my? . 14-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Spectai Needs Inmate- YES NO I: Inrnate is in need of Protection Other: mum" on a regu'ar . Date Released: 12-Sep-14 Review Completed On: . 09-Aug-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 21 Signature Reason for Current Segregation: Select length of time: 30 Days Reason: Medical Observation Medical - Other: HCU - Date 11388868114 - . ep; Review Completed On: 25-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 48 I Signature late Report Summary Printed: Page 13 or 000980 Ontario 2A5 30 Day Segregation Report Summary Region Central Region Institution Name: Toronto East Detention Centre Month Ending Year Sep 2014 Name (Last. First, Middle) Date Segregated Segregation Approval . - ?zgm?ggliepggfoa?on Reas??" froer Ziggnumg - - - I 7 8 tone - Client Identi?cation No. (mm/dwm'y) - - pp 18-Jun?14 Reason for Current Segregation; Select length of time: 30 Days Reason: Inmate remains In segregatlon YES his own request. inmate is Misconduct (Pending Adjudication) omen being assessed by psyc? Date Released: 06-Dec-14 Review' Completed On: . 19-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 171 Signature 05-May?14 Reason for Current Segregation: Select length'ol time: 90 Days Reason: Offender has numerous YES N0 Institutional Security Other. enemies ?1 thisifacmw and - . cannot go to a General Date Released: - Population unit and he has - 29_Nov_14 - refused Protective Custody Review Completed On: 04?Sep-14 Approved By: ELLIS, Lee-Ann Total of Days in Seg: Title: Sergeant 208 Signature - - . - 03-Jan-14 Reason for Current Segregation: Select length of time: ?30 Days Reason: Inmate remains segregated his own request. Inmate I Own Request Other; statement form completed. Date Released: inmate-scared of all units Review Completed On: . 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: 5 Sergeant 0" Signature late Report Summary Printed: a. wow q/Lotf Page 000981 _30 Day Segregation Report Summary late Report Summary Printed: l" - trbOntario 2A5 Region Institution Name: Month Ending 1 Year Central Region Toronto East Detention Centre Sep 2014 . Name (Last, First. Middle) Date Segregated Segregation Approval ?g?i?g?glieggfoigon Reasg? for ?Filming Coatin'f?ingliegregatPIona rova Client Identi?cation No. (mm?d?wm) . 9 pp 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: High Pro?le Case- I_Jnable to YES NO Own Request omer place Inmate Within Date Released: Review Completed On: . 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 25?Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO I: Own Request Olher. at his own request. Date Released: 16-Oct-14 Review Completed On: . 24-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 325 7 Signature 7 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: High Pro?le Case? Unable to YES NO lnsmu?onal Security ?nd suitable placement within 521(1) 1 Other: the institution at this time. Date Released: - Review Completed On: . 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: - Title: Sergeant I Signature Page 2 01000982 v4 ?F>Ontario 2AW 30 Day Segregation Report Summary Region Central Region Institution Name: Toronto East Detention Centre Sep 2014 Month Ending I Year 7 Continuing Segregation Reason for continuing Continuing Segregation Iate Report Summary Printed: Name Last, First. Middle Date Se re ated Se re ation A roval . . . . . I )9 9 pp Institutional Approval Segregation Regional Approval Client Identi?cation No. my 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains In segregation YES his own request. Claims to Misconduct (Pending Adjudication) Other: fear his safety on a" units Date Released: 11-Dec-14 Review Completed 0n: . A 19?Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 176 Signature 18?Jun-14 7 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES El NO - . - because he is unable to get . Inmate '5 "Bad 0f Pmtecuon Other: along with the other Protective Date Released: cusmdy 28-Nov-14 - (Musclingl?ghting) Review Completed 0n: 19-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant ?53 2 Signature 20?Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special News" and YES 14 2 d) Inmate is in need of Protection . ?5 unable 3? 3 Other. regular living unit. Inmate s.21(1) Date Released: assaulted Of?cerand remains "Supervisor Presentf' status at this time. Review Completed On: 19-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant I Signature Page Sat 000983 Ontario 2Aw 30 Day Segregation Report Summary Region Central Region Institution Name: - Toronto East Detention Centre Month Ending I Year Sep 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Segrega?m? segregam? . . . . Institutional Approval Segregation Regional Approval Client Identi?cation No. 22-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed Special YES No inmate is in need of Protection Other. Peeqs and is unable . - unction on a regular livmg unit. Date Released: 16-Oct-14 Review Completed On: 20-Sep-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant ?6 Signature I 22-Aug-14 Reason for Current SegregatiOn: Select length of time: 30 Days Reason: This inmate requires the use of YES [1 NO Medical - A . a back brace that cannot be Other: permitted into a regular unit. Date Released: 03-Dec-14 Review Completed On: 21-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 103 Signature 26-Aug-14 Reason for Current segregation: Select length of time: 30 Days Reason: Inmate remains segregated tor YES No I Medical omer - medical observation. . Date Released: 28-Nov-14 5' Review Completed On: . 25-Sep-14 Approved By: Jamie Total of Days in Seg: Title: Sergeant 94 Signature ate Report Summary Printed: Page 4 of000984 - .PF DJOntario 30 Day Segregation Report Summary 20 . Region lnstitution Name: Month Ending I Year - Central Region Toronto East Detention Centre Sep 2014 . Name (Last, irst, Middle) Date Segregated Segregation Approval Segregam" Reason for copt'nu'ng cont'ngmg segregat'on I I - I (mm/dd, - Institutional Approval Segregation Regional Approval Client Identification No. my . 95-Aug-14 Reason for Current Segregation: Select length of time: 90 Days Reason: Io YES No Inmate is in need of Protection Other: Mention on a U'nit and is Dare Reieased; verbally abusive towards staff 16-Oct-14 .1 Review Completed On: . 04-Sep-14 Approved By: ELLIS, Lee-Ann Total of Days in 899: Title: Sergeant 72 Signature 15-Jul?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Placed in jaggegation :Im own YES No Own Request reguest. na in - soitable placement Date Released: Review Completed ?On: 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 04-Jul-14 Reason for Current Segregation: Select length of time: 90 Days Reason: OffenIdeLI is i?unsiable and I YES [3 NO 314(2) I d) lnmate is in need of Protection . Special .96 5' He "Fab 9 I Other: I function ina regular unit s.21(1) Date Released: 08-Oct-14 Review Completed On: 04-Sep-14 Approved By: ELLIS. Lee-Ann Total of Days in 899: Title: Sergeant 96 I Signature Iate Report Summary Printed: Page 5 ?000985 - Er)0ntario 30 Day Segregation Report Summary Region Institution Name: Month Ending [Year 5C Central Region Toronto East Detention Centre Sep 2014 Name (Last. First, Middle) Date Segregated Segregation Approval segregauon Reason for coptmu'ng cont'ni?mg segregatlon - - - (mm/dd! institutional Approval Segregation Regional Approval Client Identi?cation No. my 05-Aug-14 Reason for Current Segregation: Select length of time: 90 Days Reason: Offedl?lel' is unstable and YES No - - - Special Needs. He is unable to Inmate is in need of Protection Other: function in a reguiar unit Date Released: 12-Sep-14 Review Completed 0n: 04-Sep-14 Approved By: Lee-Ann Total of Days in Seg: Title: Sergeant 38 Signature- 04?Jun?13 Reason for Current Segregation: Select length of time: 30 Days Reason: Request to remain in YES NO . . . segregation- Fears all units inmate is in need of Protection Other: incmding PG Special Needs Date Released: Previous Review Completed On: 13-Sep-14 Approved By: - HOWES. Robert Total of Days in Seg: Title: Sergeant 7 Signature 24-Jan?14 I Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO Own Request Other: . 325:3 own request. Fears all 5.21 Date Re eased Review Completed On: . 20-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant - . Signature Page 5 01000986 ate Report Summary Printed: m: .. Ontario Region Institution Name: Month Ending I Year 30 Day Segregation Report Summary 5CE . Central Region Toronto East Detention Centre Sep 2014 Name (Last, First. Middle) Date Segregated Segregation Approval Contlnulng Segregation Reason for continumg Continuing Segregation . Institutional Approval Segregatlon Reglonar Approval Client Identi?cation No. my 22-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed Special YES NO Medical Needs and Is unable to Other? functlon on a regular living unit. Date Released: 04-Nov-14 Review Completed On: 20-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 105 Signature 13-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is previous "Special YES NO Inmate is in need of Protection Other. Neeqsu and '5 unable}? . - function on a regular unit. Date Released: 04-Nov-14 Review Completed On: 13-Sep-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant I 83 Signature 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated YES NO Inmate is in need of Protection . becai?se he '5 unable 3? Other- function on a regular living 5 21(1) Date Released: unit. Inmate threatens to 14_Nov_1 4 assault other inmates; Review Completed 0n: 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant I 364 Signature iate Report SUmmary Printed: - Page 7 01 000987 30 Day Segregation Report'Summary f" Ontario 50W Month Ending I Year Sep 2014 Institution Name: Region Toronto East Detention Centre Central Region Name (Last, First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation I Institutional Approval Segregation Regional Approval Client Identification No. WV . 02-Jul-14 Reason-for Current Segregation: Select length of time: 30 Days Reason: YES NO Inmate is in need of Protection Other: Date Released: Review Completed On: 29-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant I I I Signature 29-May-14 Reason for Current Segregation: Select length of time: 30 Days . Reason: Inmate remains segregated YES NO edi 68' because he is possible Other: "Special Needs" and is unable Date Released; to function on a regular Iiving 09?Nov-14 Review Completed On: 01-Oct?14 Approved By: PERKINS. Jamie Total of Days in Seg: - Title: Sergeant 16-4 . Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated YES NO - - - because he is possible Inmate IS in need of Protection Other: - "Special Needs" and is unable - to function on a regular living Date Released. unit I s.21(1) Review Completed 0n: 01-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature Page 8 ?#000988 late Report Summary Printed: Ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I'Year 5C Central Region Toronto East Detention Centre Sep 2014 - Name (Last. First, Middle) Date Segregated Segregation Approval segregat'on Reason for 00ml"?an segregation (mm/dd, institutional Approval Segregation Regional Approval Client Identification No. . WW . 03-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains In segregation YES [3 N0 [3 - - - because of previous 'nSt'lumnal Secumy Other: Institutional behaviour. Date Released: 01-Oct-14 Review Completed 0n: 13-Sep-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 240 . Signature 25-Jul-14 Reason for Current Segregation: Select length of time: Reason: inmate released from custodySATS Inmate is in need of Protection Other: (Sept 22 201% Date Released: 23-Sep-14 Review Completed On: 23-Sep-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 60 Signature s.21(1) late Report Summary Printed: Page 9 of 000989 we. I Ontario 30 Day Segregation Report?Summary Month Ending I Year I Name (Last. First. Middle) . Client Identi?cation No. I late Report Summary Printed: Region Institution Name: Central Region Toronto East Detention Centre Oct 2014 Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation institutional Approval Segregation Regional Approval 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregated own request. Inmate is - Misconduct (PendingrAdjudtcation) Other. possible "Special Ne?dsu and Date Released: - is unable to function on a 06_Dec_1 4 regular living unit at this time. Review Completed On: . Approved 'By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 171 Signature 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate requests to' be YES I: NO institutional Security Other: $99'egated' ?We ?39' Date Released: s.21(1) Review Completed On:- 14-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 0 Signature 17-Sep?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needs" and YES N0 Medical is unable to function on at Other: regular living unit at this time. 'Date Released: - 25-Oct?14 Review Completed On: . 7 17-Oct-14 Approved By: Jamie Total of Days in Seg: Title: Sergeant 3-8 - Signature Mm mm" Page 1 of 000990 30 Day Segregation Report Summary late Report Summary Printed: . ?gf'bOntario ZAE Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 Name (Last First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for coIntInumg Continuing Segregation . . . . Institutional Approval Segregation Regional Approval Client Identification No. WW I I I 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate requests to be YES NO Own Re "est 7 segregated. Claims to fear . Other: safety. Date Released: Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie I Total of Days in Seg: - . Title: Sergeant . Signature 29-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls segregated 0" NO I: Own Re ?est request due to his relationship Other: in the past with a law Date Released: enforcement of?cer. Fears all 14-Nov-14 Review Completed On: . I 29-Oct-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 46 I Signature I I 05-Maiy-14 Reason for Current Segregation: Select length of time: 30 Days Reason: lannate refuses to go to any YES No lnstimtionar Security I unit and refuses to sign into Other- Protectlve Custody. Says hes . 521(1) Date Released: line right there A 29-Nov-14 Review Completed On: I 04-Oct-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 208 . Signature page 2 ?000991 Iate Report Summary Printed: 000992 30 Day Segregation Report Summary 7" Ontario - . 2Aw Region Institution Name: Month Endinq'l Year Central Region Toronto East Detention Centre Oct 2014 Name (Last. First, Middle) Date Segregated S?grega?on Approval Continuing Segregation . Reason for continuing Continuing Segregation (mm/dd, - Institutional Approval Segregation Regional Approval Client Identi?cation No. my 7 22-Aug-14 Reason for Current Segregation: Select length of time: 30-Days Reason: Inmate ts segregated as per YES NO Medical Other: medrcal. - Date Released: 03-Dec-14 Review Completed On: 21-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: ,Title: Sergeant 103 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate request to be y?S No Own Request Other: segregated. High pro?le case. Date? Released: Review Completed 0n: 14-Oct-14 Approved By: PERKINS. Jamie. Total of Days in Seg: Title: Sergeant - Signature 18-Jun-14 Reason for Current Segregation: . Select length of time: 30 Days- Reason: Inmate is'segregated because - . i . YES NO Inmate is in need of Protection omer. he Preys 9" ?he? "?ma'es' 5-2133?) . 5. Date igl?sfd; Review CompIeted On: 4 - 20-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Titlez' Sergeant 163 I Signature Page 3 of .r?y tr?omano 30 Day Segregation Report Summary Region Institution Name: Month Ending [Year ZAW 7 Central Region Toronto East Detention Centre Oct 2014 Name (Last. First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . . I (mm/dd] institutional Approval Segregation Regional Approval Client identi?cation No. WW 23-Sep?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES [j NO - - . Needs" and is unable to 0 I lnma?e '5 In new Of Prmectlon Other: iunctlon on a regular living unit. Date Released: Review Completed On: 24-Oct-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 11-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation for another misconduct - Misconduct (Pending Adjudication) Other: investigation of staff 8553"". Date Released: 17-Oct?14 Review Completed On: I 14-Oct-14 Approved By: - PERKINS. Jamie Total of Days in Seg: 7 Title: Sergeant 36 Signature 11-Sep-14 Reason for Current Segregation: Select length oi time: 30 Days Reason: inmate is_segregated pending YES NO Misconduct (Pending Adjudication) om?r. . "Wash-9am? assau? 5m"- - . s.21(1) Date Released: 5 14-Nov-14 Review Completed 0n:_ 14-Oct-14 Approved By: .. PERKINS, Jamie Total of Days in Seg:' Title: Sergeant 64 Signature Page 4 of late Report Summary Printed: 000993 I v; Ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year late Report Summary Printed: 2AW Central Region Toronto East Detention Centre Oct 2014 Name (Last. First. Middle) Date Segregated Segregation Continuing Segregation Reason for continuing Continuing Segregation I I I (dedW . Institutional Approval Segregation Regional Approval Client Identi?cation No. 5' . - 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inngiate remains seg?r?elgatedl YES 7 NO - - - a sownreques. prore - Misconduct (Pending Adjudication) Other: case. Date Released: 11?Dec-14 Review Completed On: 20-OCI-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 176 - Signature 26-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate requires placementin YES No El Medicai I segregation for medical Other: purposes at this time. Date Released: 28-Nov-14 Review Completed On: 25-Oct-14 Approved By: HOWES, Robert Total of Days in Bag: Title: Sergeant I 94 Signature 29-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate was involved?in a YES NO Medical phyical altercation With seg. Other- cellpartner. 5.21 (1 Date Released:_ 02?Oct-14 Review Completed 0n: I 01-Oct-14 Approved By: PERKINS. Jamie II Total of Days in Seg: Title: Sergeant 65 . . "Signature Page 5 of 000994 30 Day SegregationReport Summary . 'trbOntario 2C Region Institution Name: Month Ending 1 Year Central Region Toronto East Detention Centre Oct 2014 7 Name (Last, First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . . Institutional Approval Segregation Reg onal Approval Client Identi?cation No. my 20-Aug-14 Reason for Current Segregation: Select length ottime: 30 Days Reason: Inmate is "special Needsunable to uno ion on a Inmate is In need of Protection Other: regular living unit Date Released: Review Completed On: 20-Oct-14 Approved By: PERKINS, Jamie I Total of Days in Seg: Title: Sergeant Signature 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregated tor YES NO I: d. I medical observation. Other: Date Released: 14-Nov-14 Review Completed On: 20-Oct-14 Approved By: PERKINS. Jamie Total of Days in Bag: Title: Sergeant 56 I Signature 05-Aug-14 Reasbn for Current Segregation: Select length of time: 30 Days Reason: Inmate is Special needs and unable to cope or function Other: reg unit 521(1) Date Released: 16-Oct-14 Review Completed On: 04-Oct-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 72 -- . . Signature late Report Summary Printed: Page 6 of 000995 I?ve, Ontario 30 Day Segregation Report Summary Month Ending I Year 20 Region Institution Name: . Central Region Toronto East Detention Centre Oct 2014 Name (Last. First Middle). Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation . (mm,dd, Institutional Approval . Segregation Regional Approval Client Identi?cation No. I my . 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO Medical Other. on medical onservatlon. Date Released: 0 Review Completed On: 20-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant . Signature 13-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: find Is YES No Misconduct (Pending Adjudication) Other: assaumng Date Released: 04-Nov-14 Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie. Total of Days in Seg: Title: Sergeant 52 Signature 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is ?Speclal Needs" and YES NO Medica! Is unable to function on a 321(1) Other: regular living unit. Inmate is Date Released: also segregated at his own request Review Completed On: 31-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: - Title: Sergeant Signature Page 7 of Iate Report Summary Printed: 000996 Ontario 30 Day Segregation Report Summary 5CE Region institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 i Name (Last, First. Middle) Date Segregated Segregation Approval segregat'on' Reason for copt'numg segregatlon I . (mm?ddf Institutional Approval Segregation Regional Approval Client Identi?cation No. WW 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is possible "Special YES I: NO Own Re ?est Needs" and is unable to Other: function on a regular unit. Date Released: Review Completed On: 08-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: I Title: Sergeant Signature 22-Jul-14 Reason for Current Segregation: _Selectlength of time: 30 Days Reason: Inmate is possible "Special YES No . Medical Needs" and is unable to I Other: function on a regular livlng unit Date Released: 3' "me- 04-Nov-14 Review Completed On: 20-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 105 I A . Signature I 24-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated at N0 El 7 Own Re uest . his own request claims to fear: Other: safety on all units. Date Released: s.21(1) - Review Completed On: I 20-Ocl-14 Approved By: PERKINS. Jamie Total of Days inSeg: Title: Sergeant . 7_ Signature late Report Summary Printed: Page 8 of. ,000997 30 Da Se re ati ort Summar' . 9 9 on an Ontario Month Ending 1 Year late Report Summary Printed: 5CE Region institution Name: Central Region Toronto East Detention Centre Oct 2014 Name (Last, First, Middle) Date Segregated Segregation Approval somir?tf?ingliegregatiion Reasson for Continumg coatinumg Sigregatlion . . - ns I iona pprova a re ation ional rova Client Identi?cation No. (mm?dd?my) 9 pp 02-May~14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES No Inmate is in need of Protection . News and '5 ?name? . 7? . - Olhef- function on a regular livmg unit. Date Released: 14-Nov-14 Review Completed On: 01-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: I Title: Sergeant 196 Signature 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO -, Medica' - because he is "Special Needs" Other: and is unable to function on - Date Released: regular living unit. Review Completed On: 01?Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature . 30-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: YES No Inmate IS in need of Protection Oiher: function on a regular living unit. 321(1) Date Released: 09-Nov-14 Review Completed On: 31-Oct-14 Approved By: PERKINS, Jamie Total ofDays in Seg: Title: I Sergeant 71 I Signature. Page 9 of 1000998 1000999 5 30 Day Segregation Report Summary Ontario - . 50E Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 Name (Last First. Middle) Date Segregated Segregation Approvw Continuing Segregation Reason for continuing Continuing Segregation (mm/dd, institutional Approval Segregation Regional Approval Client Identi?cation No. my 02-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is "Special Needsunable to'function on a Inmate Is In need of Protection Other: regmar living unit. Date Released: 14-Nov-14 Review Completed On: 31-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 196 Signature 30-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES No Medical own request. Inmate is unable - Other: to function on a regular living Date Released: unit at this time. IS-1 09-Dec-14 821(1) Review Completed On: 31-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 193 7 Signature 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is Special Needsunable to function on a inmate is in need of Protection Other: gregular ?ving uniL Date Released: 15-Nov-14 Retriew Completed On: 08-Oct?14 Approved By: PERKINS. Jamie Total oi Days in Seg: Title: Sergeant 68 Signature Page 10 of late Report Summary Printed: Ontario 30 Day Segregation Report Summary Month Ending I Year late Report Summary Printed: 001000 5C Region Institution Name: Central Region Toronto East Detention Centre Oct 2014 I - . - Continuing Segregation Reason for continuing Continuing Segregation re ated Se re ation A roval . . . . Name (LaSt' Middle) )9 9 pp Institutional Approval Segregation Regional Approval Client Identi?cation No. my 04-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is special needs and cope or uncl on on Inmate IS In need of Protection Other: reg uni. Date Released: 08-Oct-14 Review Completed On: 04-Oct-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 96 . SignatUre 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Speciat YES NO Needs" and is unable to - Own Request Other: function on regular living unit. 521(1) Date Released: 5.21 Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie - Total of Days in Seg: Title: Sergeant Signature 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: lnmata ls "Special Needsunable to fucntlon on a Inmate IS In need of Protection omen regular living ?hit Date Released: Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature Page 11 of 1 fay") Ontario 30 Day Segregation Report Summary Month Ending I Year 5cw Region Institution Name: Central Region Toronto East Detention Centre Oct 2014 A Name (Last, First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation 7_ institutional Approval Segregation Regional Approval Client Identi?cation No. my 7 13-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special NO- - . . . Needs?andisunabbto Inmate '5 need 0f ProteCt'on Other: function on a regular living unit. Date Released: 04-Nov-14 Review. Completed On: 14-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 83 I Signature 11?Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES No [Special needs Needs" and is unable to - - - Other: function on a regular living unit. Date Released: 24-Oct-14 Review Completed-On: 14-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: I Title: Sergeant 43? . Signature 29-Sep-14 Reason for Current Segregation: Selectlength of time: 30 Days Reason: Inmate is considered Special YES [3 NO Inmate is in need of Protection Needs and is "name t? Other: function on a regular unit. s.21(1) Date Released: Inmate would not be able to 21(2)(f) 26_N0v_14 comply with unit rules Review Completed On: 29-Oct-14 Approved By: HOWES. Robert Total of Days in Seg: Title: . 7 Sergeant 58 Signature Page120f1 late Report Summary Printed: 001001 n4 {>20ntario 30 Day Segregation Report Summary Month Ending I Year 5cw Region Institution Name: Central Region Toronto East Detention Centre 1 Oct 2014 Name (Last, First. Middle) Date Segregated Segregation 'Approval segregauon Reason for cont'ny'ng segregauon . Institutional Approval Segregation Regional Approval Client Identi?cation No. WW . 29-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needs" and YES [3 N0 El Medical is? unable to function on a Other: regular living unit. Date Released: 09-Nov-14 Review Completed On: 7 31-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 164 Signature ?1 5-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is not able to function YES No . - onreguhr??ngUn?e Inmate Is in need of Protection Other: Threatens? assault other Date Released: Inmates. 14-Nov-14 Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 354 Signature 02?Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls"'Speciai Needs" and YES NO [3 Inmate is in need of Protection is "name l? ?mam? 3 - 521(1) Other: regular living unit at this time. Date Released: Review Completed On: - 31-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: 7 Sergeant - . Signature. -Page13of1 late Report Summary Printed: 001002 30 Day Segregation Report Summary - b5) . Ontario Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 Name (Last First Middle) - Date S?gregated Segregation ApprovaI Continuing Segregation Reason for continuing Continuing Segregation (m [dd/y Institutional Approval Segregation Regional Approval Client Identi?cation No. 12-Sep-14 Reason for Current Segregation: Select length of time: Reason: Released to 40 Unit on this YES [3 NO [1 Medical Other: date' Date Released: 14-Oct-14 Review Completed On: 14-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant I 32 Signature 521(1) late Report summary Printed: - Page14of 001003 . is; Ontario 30. Day Segregation Report Summary Month Ending I. Year late Report Summary Printed:- ZAE Region Institution Name: I Central Region .Toronto East Detention Centre Nov 2014 Name (Lash First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continurng Continuing Segregation . (mmiddf Institutional Approval Segregation Regional Approval Client Identi?cation No. I I 18-Jun-14 I Reason for Current Segregation: Select length of time: 30 Days Reason: inmate continues "est segregation as he refuses to Other: leave. Fears for safety and Date Released; there Is no area to proper 06_Dec_14 place him where he feels safe. 7 Review Completed On: I 20-Nov-14 Approved By: HOWES, Robert Total of Days in Seg: - Title: Sergeant 171 Signature 05-May-14 Reason for Current Segregation: Select length of time: 3-0 Days Reason: Inmate is segregated at his YES NO I Institutional Security omen request- Date Released: 29-Nov-14 Review Completed On: 03-Nov?14 Approved By: I PERKINS. Jamie Total of Days in Seg: Title: Sergeant 208 Signature 31-Jan-14 Reason for Current Segregation: SelectIlength of time: 30 Days Reason: Inmate is segregated at his YES NO Institutional Security Other: request ?due: Date Released: Review Completed 0n: I I . 13-Nov-14 I Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant a . . Signature I. Mtg? Wet ?7.th Page 1 of ,001004 30 Day Segregation Report Summary i" ?250 ZAE - . Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Nov 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg. Continuing Segregation . . . Institutional Approval - Segregation Regional Approval Client Identi?cation No. WW - . . 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days. Reason: Inmate is segregated at his YES NO Own Request . i own request. Claims to fear I Other: safety on all units. Date Released: Review Completed 0n: 13-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 11-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate was transferred on this YES NO Misconduct (Pending Adjudication) Other: date: Date Released: i 14-Nov-14 Review Completed 0n: 13-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 64 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls segregated uesl . own request and claims that - s' . Other: he fears his safety. 821(1) Date Released: .ReView Completed On: 13-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: I Sergeant - Signature Page 2 of 001005 late Report Summary Printed: 30 Day Segregation Report Summary late Report Summary Printed: r~ . try??0 2Aw Region I Institution Name: Month Ending I Year . Central Region Toronto East Detention Centre Nov. 2014 I Name (Last, irst, Middle) Date Segregated Segregation Approval Reasgn for czptinumg coatinyingliegregation . . na rova re a ton Iona rova Client Identi?cation No. (mm/?NW? pp . 9 pp 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate requests Segregation._ YES No Own Requesi Olher' Fears for safety Date Released: 11-Dec-14 Review Completed On: 20-Nov-14. Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant 175 Signature 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate cannot get along ivith YES - NO - - - other PC inmates. Continues inmate is in need of Protection Other: pick ?ghts and preys on Date Released: them. Inmate is poss SNU 28-Nov-14 Review Completed On: 20-Nov-14 Approved By: HOWES, Robert Total of Days in Seg: I Title: Sergeant 163 7 Signature 22-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Requires the use of a back- YES - NO - - brace that cannot be permitted s_14 2 Medical Other: in any of the inmate living units 21 1 Date Released; due to the materials that it is s' 030864 4 bailt of. Review Completed On: . 20-Nov-14 Approved By: HOWES, Robert Total of Days in Bag: I Title: Sergeant 103 Signature Page 3 .001006 f?P - 'i?'D?Ontario 30 Day Segregation Report Summary Month Ending I Year ZAW Region Institution Name: Central Region Toronto East Detention Centre Nov 2014 Name (Last, First, Middle) Date Segregated Segregation Approval segregat'on Reason for copt'numg cont'ng'ng segregat'on A . (mm/dd] Institutional Approval Segregation . Regional Approval Client Identification No. my 20-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate continues numerous assaults against Misconduct (Pending Adjudication) Other: staff and ongoing misconducla Date Released: 03-Dec-14 Review Completed On: . 20.Nov??I4 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 44 Signature 22-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is Special needs and YES No - - - - would be unable to function on inmate is in need of Protection Other: 8 legular inmate living unit Date Released: 29-Nov-14 Review Completed 0n: 21-Nov-14 Approved By: Robert Total of Days in Seg: Title: Sergeant 38 Signature 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated due to YES No Medical I medical observations but is I Other: also requesting to remain in Date Reieased: . segregation "fears for safety" Review Completed On: 20-Nov-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant Signature s.21(1) Ia?te Report Summary Printed: 001007 Page 4 of late Report Summary Printed: EV) 30 Day Segregation Report Summary - Ontario . . 2C Region Institution Name: Month Ending Year Central Region Toronto East Detention Centre Nov 2014 Name (Last, First. Middle) Date Segregated Segregation Approval Contintiing Segregation Reason for continumg Contintiing Segregation . (mmidd, Institutional Approval Segregation Regional Approval Client Identification No. my 26-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated for YES NO Medical 0m medical reasons. I I er: - Date Released: 28-Nov-14 Review Completed On: 24-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 94 Signature - 20-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Loggia: 55:21:: ?eld; YES No I Inmate is in need of Protection Other: inmate living unit as he Wm be Date Released: unable to function. Review Completed On: 20-Nov-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant . Signature 04-Jun-13 . Reason for Current Segregation: Select length of time: 30 Days Reason: and YES NO - Inmate is in need of Protection Other: reguiar Wing unit. Date Released: Review Completed On: - - . 13-Nov-14 Approved By: I PERKINS, Jamie Total of Days in Seg: I Title: Sergeant Signature snzuzxd) saz1u) Page 5 of .001008 FF) - 0? Ontario 505 30 Day Segregation Report Summary Region Central Region Institution Name: Toronto East Detention Centre Nov 2014 Month Ending I Year Name (Last. First] Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation I . 7 Institutional Approval Segregation Regional Approval - Client Identi?cation No. - my 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate has been deemed YES [7 N0 Medical ?Special Needs" and is unable . Other: to functionon a regular living Date Released: unit. Review Completed On: . 28-Nov-14 Approved By: 7 PERKINS. Jamie Total of Days in Seg: Title: Sergeant I I Signature 08-Sep-14 Reason for Current Segregation: Seiecl length of time: 30 Days Reason: Inmate is possible "Special YES NO Inmate is in need of Protection Other. . Feats and '5 unable}? . i - unctron on a regular unit. Date Released: 15-Nov-14 Review Completed On: 07-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 63 Signature 08-Sep?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES NO i own Requesk needs? and is unable to _Other: function on a regular living unit. Date Released: Review Completed 0n: 07-Nov-14 - Approved By: Jamie Total of Days in Seg: Title: Sergeant Signature ate Report Summary Printed: sL14(2)(d) s.21(1) Page 6 0 ?1001009 . 55?) Ontario 30 Day Segregation Report SLImmary Region Institution Name: Month Ending I Year late Report Summary Printed: 5CE . Central Region Toronto East Detention Centre Nov 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Coqt'nymg segregatlon Reason for Gont'ngmg segregat'on . (mmkid, . Institutional Approval Segregation Regional Approval Client Identi?cation No. WW 30?May-14 Reason for Current Segregation: Select length of time: - 30 Days Reason: Inmate has been desired by YES No Medical psyc. But wants to remain in Other: seg. Unable to function on a Date Regeased; regular living unll. 09-Dec-14 Review Completed On: 28-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 193 Signature 31 Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES NO - . . . Needs" and is unable to Inmate Is need or Pwtecuon Other: function on a regular living unit. Date Released: Review Completed On: . 28-Nov~14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 24-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate fears for safety In all YES NO Own Requesl . Inmate Iivlng units. Unable to i . Other: place him anywhere Date Released: Review Completed On: 207Nov-14 Approved By: HOWES, Robert Total of Days in Seg: Title: Sergeant . Signature s.21(1) Page 7 Of we); . Ontario 30 Day Segregation Report Summary Region lnstitution Name: Month Ending I Year 5CE . Central Region Toronto East Detention Centre Nov 2014 - Name (Last. First Middle) Date Segregated - Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . - Institutional Approval Segregation Regional Approval Client identi?cation No. WW - - . 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "special Needs" and YES No Own Re uesl . a is unable to function on a - Other: regular living unit. Date Released: Review Completed On: 13-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 17-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES NO - . needs" and is unable to Inmate Is In need of Protection Other: function on a regular living unit Date Released: at this time. 20-Nov-14 Review Completed On: . 17-Nov-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 64 . - Signature 22?Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is special needs and YES N0 Medical remains in segregation as he Other: ls unable to function on a Date Reieased: regular inmate living unit Review Completed On: I A 21-Nov-14 Approved By: HOWES. Robert Total of Days in Seg: . Title: sergeant Signature late Report Summary Printed: s.21(1) Page 8 of 001011 If?; Ontario Month Ending I Year 30 Day Segregation Report Summary 50w Region Institution Name: CentralRegion Toronto East Detention Centre Nov 2014 Name (Last. First, Middle) Date Segregated Segregation Approval segregat'on Reason for coptmumg comingmg segregatlon . . Institutional Approval Segregation Regional Approval Client Identi?cation No. . . 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate was moved on this YES I: No Inmate Is in need of Protection . date to . Other. assessment. Date Released: Review Completed 0n: 13-Nov-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 364 Signature 17-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed as Special YES CI No Medical Needs and is unable to cope Other: or function on a regular inmate Date Released: living unit Review Completed On: 17-Nov-14 Approved By: HOWES. Robert - Total of Days in Seg: I Title: Sergeant Signature 24-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is ?Special Needs" and YES I: . NO Inmate is in need of Protection - is unable t? mam" a . Other: regular living unit. 521(1) Date Released: Review Completed on: 24-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant '7 Signature late Report Summary Printed: Page 9 of 001012 I 30 Da t' mmar . I egrega ion epo Ontario late Report Summary Printed: 53w Region institution Name: Month Ending I Year Central Region Toronto East Detention Centre - Nov 2014 Name (Last. First. Middle) Date Segregated Segregation Approval Segregat'on Reason for copt'nu'w commp'ng segregat'on I I institutional Approval Segregation Regional Approval Client identi?cation No. - my 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregated because YES No . . . he is "Special Needs" and is Inmate is in need of? Protection Other: unable to function on a regular Date Released: living unit. Review Completed On: I 28-Nov?14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 03-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needsunable to function on a - inmate ism need of Protection Other: regu'ar living unit. Date Released: 09-Nov-14 Review Completed 0n: 03-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 3?7 - Signature 23-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needsunable to function on a inmate is in need of Protection Other: regular living unit. Date Released: s.21(1) Review Completed 0n: 24-Nov-14 I Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant . Signature Page 10 of 001013 ElyDay Segregation Report Summary 5' Ontario - I ZAE . Region Institution Name: . . Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 . Name (Last, First,'Middle) Date Segregated Segregation Approval segregat'on Reason for coptmu'ng vcont'nymg segreganon . . . - -- Institutional Approval - Segregation Regional Approval Client Identi?cation No. WW . - - 03-Jan-14 - Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES No Own Re uesl . own request. Fears safety at . 9 Other: this instution. Date Released: - Review Completed On: 12-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant . Signature 04-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES NO Medical - - own request. Calims to have - Other: medical issues. Date Released: - Review Completed 0n: . - 03-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: I Sergeant Signature 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES No Institutional Securit I request Fears safely 5114(2Hd) Other: because of high pro?le s.21(1) Date Released: - - charge?? . Review Completed On: 12-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature Marta/2; a 400/ .Pagetor001014 'ate Repdrt Summary Printed: 30 Day Segregation Report Summary r~ . ZFy'Ontario ZAW Region Institution Name: Month Ending I Year 7 Central Region Toronto East Detention Centre Dec 2014 Name (Last. irst; Middle) .Date Segregated Segregation Approval Commitmg segregat'on Reason for con?nying segregatlon I . . (mmidd, institutional Approval Segregation Regional Approval Client Identification No. WW . . 07-Feb-14 Reason for CUrrent Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his - I YES No Own Request - own request. Fears safety from ()U1er: othero?enders.? Date Released: Review Completed On: 12-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 05-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES No 14(2)(d) Own request Needs" and is In segregation . Other: at his own request. 5.21 (1 Date Released: 12-Dec?14 Review Completed 0n: 05-Dec-14 Approved By?: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 37 Signature 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated for YES No Medical 0m medical observation. - . er: . Date Released: Review Completed On: 17-Dec-14 . Approved By: PERKINS, Jamie Total of Days in Seg: I Title: Sergeant - - Signature' PageZef tale Report Summary Printed: 001015 . DJOntario 30 Day Segregation Report Summary Month Ending I Year 2C Region Institution Name: . Central Region Toronto East Detention Centre Dec 2014 Name (Last. First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation Institutional Approval Segregation Regional Approval Client Identification No. my . 20-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate renfiains segregated [3 NO . . . - because 0 two assaults on inmate is in need of Protection Other: ska?. Inmate is also "special Date Released: Needs" and is unable to function on a regular living unit. Review Completed On: 17-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 26-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated own request. Inmate is being inmate is in need of Protection Other: transferred to TSDC on Date Released: Menday Dec 29 2014. Review Completed On: 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated uesl - - own request. Refuses to leave A . Other: segregation. - 5.21 (1 Date Released: Review Completed On: 12-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: 1 Title: Sergeant - . Signature Iate Report Summary Printed: Page 3 f001016 Ontario 30 Day Segregation Report Summary - 5CE Region Central Region Institution Name: Toronto East Detention Centre Dec 2014 Month Ending [Year Continuing Segregation Name (Last, First. Middle) Date Segregated Segregation Approval Segregat'on Reason for cor'l'mmg - (mm/dd! Institutional-Approval Segregation - Regional Approval Client Identi?cation No. my . 31-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregatgd YES "Special Nee s" an is Inmate IS In need of Protection Other: qn?ab'e '9 function on a {egular Date Released: ?Vlng Review Completed 0n: 28-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated athls YES No A t. Fears safety. Own Request Other: ?wn reques Date Released: Review Completed On: . 05-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 24-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Speclal YES No . . Needs" and is unable to Inmate Is In need of Protection Other: function on a regular ?wing unit. Date Released: 'Review Completed On: I 24-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant - . Signature late Report Summary Printed: 521(1) Page 4 of 001017 EV). 30 Day Segregation Report Summary Ontario Month Ending I Year late Report Summary Printed: 50E. Region Institution, Name: Central Region Toronto East Detention Centre Dec 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Segregat'on Reason for Copt'numg cont'nymg segregat'on - (mm/dd] . - Institutional Approval Segregation Regional Approval Client Identification No. WW - 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is "Special Needsunable to unction on a Inmate is in need of Protection omen regular living unit. N50 . Date Released: Inmates on request. Review Completed On: - 12-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant . Signature I 19?Nov?14 Reason for Current Segregation: Select length of time: . 30'Days Reason: Inmate remains segreQaIEd YES I: NO . . . because he is previous Inmate is in need of Protection Other: "Speciai Needs" and is unable Date Released: to function on a regular living unit.- Review Completed On: 17-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregatedlbecause YES No 5-1 Medical he is SpeCiaI Needs and is . Other: unable to function on a regular s.21(1) Date Released: living unit- Review CompletedOn: 28-Dec-14 Approved By: HOWES, Robert Total of Days in Seg: Title: I I Sergeant Signature Page 5 of 001018 . 30 Day Segregation Report Summary I Ontario - - 5CE Month Ending I Year Dec 2014 Institution Name: Region Toronto East Detention Centre Central Region Name (Last, First] Middle) Date Segregated Segregation Approval Continuing Segregation Reason for Continuing Segregation middj . institutional Approval Segregation Regional Approval Client Identification No. WW 22-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed as Special YES NO Medical Needs and is unable to . I Other: function or cope on normal Date Released: inmate living unit Review Completed On: 21-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 20-Nov-t4 Reason for Current Segregation: Select length of time: 30 Days Reason: Emits is pic?ssible "lspecial YES unab to Inmate Is In new Of Pmtecmn functlon one regular living unit. Date Released: 29-Dec-14 Review Completed On: 17-Dec-14 Approved By: PERKINS, Jamie Total #Iof Days in Seg: Tille: Sergeant 39 . Signature 24?Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated "85? his own request. Fears his Other: safety on units. 521(1) Date Released: Review Completed On: . 17-Dec-14 Approved By: I PERKINS, Jamie Total of Days in Seg: Title: Sergeant . . Signature late Report Summary Printed: I Page-6 of001019 001020 of fit?3, . 30 Day Segregation Report Summary Ontario 50w Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 Name (Last. First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . . (mmidd, Institutional Approval Segregation Regional Approval Client Identification No. my 24-Oct-14 Reason for Current Segregationz. Select length of time: 30 Days Reasonf Inmate is previous ?Special NO inmate is in need of Protection Other. A Needs and. requests t? ?em'a" - . in segregation. Date Released: Review Completed On: 24-Dec-14 Approved By: PERKINS. Jamie Total of_ Days in Seg: Title: Sergeant Signature 02-Jul-14 Reason for Current Segregation: Select length oftime: 30 Days Reason: YES NO inmate is in need of Protection unable to function on a mum" Date Released: ?Ving Review Completed On: 28-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 17-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is unable to function on YES NO Medicai I a regular unit due to special I 21 1 Other. needs and SpeCIal Health 3' Date Released: Care ?99?5 Review Completed On: 17-Dec-14 Approved By: HOWES, Robert - Total of Days in Seg: Title: Sergeant I Signature Page 7 late Report Summary Printed: 30 Day Segregation Report Summary - #50 50w Region Institution Name: Month Ending 1 Year . Central Region Toronto East'Detention Centre Dec 2014 - Name (Last First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation I I . institutional Approval Segregation Regional Approval Client Identi?cation No. WW - 23-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: {Smite s"an isuna Inmate '3 In "Bed Of Pro?ewon Other: function on a regular living unit. Date Released: Review Completed On: 24-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant Signature 05-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is "Special Needsunable to function on a . Other: regular living unit. Date Released: Review Completed On: 05-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant I Signature 25-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is possiblengpecial YES No . - Needs" and is una to . inmate IS In need of Protection Other; function on a regular living unit. Date Released: Review Completed On: 24-Dec-14 Approved By: PERKINS, Jamie Total of Days in Seg: I Title: Sergeant Signature iate Report Summary Printed: s.21(1) Page 8 (,001021 5F Ontario 30 Day Segregation Report Summary . 50w Region Institution Name: - Month Ending I Year . Central Region Toronto East Detention Centre - Dec 2014 i - - - Continuing Segregation Reason for continuing Continuing Segregation Name (Last F'rSt' M'ddle) ?atid??grigated segregat'on Approval Institutional Approval Segregation . RegionalApprov'al Client Identi?cation No. mm - my 18-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is segregated at his YES No iate Report Summary Printed: Inmate is in need of Protection Date Released: Review Completed On: Other: Total of Days in Seg: own request. Claims that he is "Special needs". being assessed by psyc. 17-Dec-14 Approved By: PERKINS. Jamie Title: Sergeant Signature 13-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: lnmatt': is "Special Needsunction on a . Inmate is in need of Protection omen 'egular living unlL Date Released: Review Completed On: 12-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant . Signature - 521(1) Page 9 ol001022 5121(1) Regional 30 Day Segregation Report 5.21 Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar month. Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into the next reporting month once they have reached the 30 continuous days in segregation Inmate is admitted to segregation onSeptember 5th will be captured in the October report if more than 30 continuous days). Central Region ?r 'c Vanier centre for Women To protect the security of the institution or the safety of other inmates - 001023 nrha presen as ona an a historyof aggressive behaviour towards Staff and other Inmates -Rejected Mental Health Issues . - 001024 Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar month. I Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into the next reporting month once they have reached the 30 continuous days in segregation Inmate isadmitted to segregation on September 5th will be captured in the October report if more than 30 continuous days). i? lime tied in segregayon. (Mr?r? dart/m) v. 4 .. Vanier Centre for Wo men 001025 Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar month. Note: If the inmate has not reached the 30 continuous days in the month identi?ed, it will carried over into the next reporting month once they have reached the 30 continuous days in segregation Inmate is admitted to segregation on September 5th will be captured in the October report if more than 30 continuous days). Vanier Centre for Women NIL NIL 001026 Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar month. Note: If the inmate has not reached the 30 continuous days in the month identi?ed, it will carried over into the next reporting month once they have reached the 30 continuous days in segregation Inmate is admitted to segregation on September 5th will be captured in the October report if more than 30 continuous days). Central Region A Vanier Centre for Women 001027 Regional 30 Day Segregation Report Report details consists of inmates admitted to segregation for a period of 30 continuous days in a calendar month. Note: If the inmate has not reached the 30 continuous days in the month identified, it will carried over into the next reporting month once they have reached the 30 continuous days in segregation Inmate is admitted to segregation on September 5th will be captured in the October report if more than 30 continuous days). Vanier Centre for Women - 001028 Ontario 50w 30 Day Segregation'IRepo'rt Summary Region Institution Name: . Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 .dme (Last. First. Middle) Date Segregated Segregation Approval lient identification No. (mm?dd?VWV)' 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains In segregation YES No . because a threatens to Inn-mite ls "1 need Of Pmlecuon Other: . assault other inmates. lnmate - Date Released: - Is not able to iunctlen on a 1 4_Nov_14 -regular living unit. Review Completed On: 13-Aug-14 Approved By: PERKINS. Jamie Total It of Days in Sag: Title: Sergeant 364 . Signature 25-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is deemed?lspteclal YES NO . - - needs and la una Inmate '3 In need of Protection other: function on a regular [nmala Date Released: "m9 21 23-Sep-14 Review Completed 0n: - 24-Aug-14 Approved By: HOWES. Robert Total it of Days in seg: Title: Sergeant 60 . Signature 03-Feb?14 Reason for Current Segregation: Select length of time: 30 Days Reason: 3npradlcab:a behaviour. YES No noble to ace on a regular Institutional Security Other: - A . Date Released: 01-Oct-14 Review Completed Dn: 09-Aug-14 Approved By: HOWES. Robert Total of Days in Segz' Title: Sergeant 240 I Signature a Report Summary Printed: Page 160! 1B . . . 30 Day Segregation Report Summary Ontario . 50E Region Institution Name: Month Ending I Yea . Central Region Toronto East Detention Centre Aug 2014 . am, (Last. Firsl? Middle) Date Segregated Segregauon Approval Continuingl??fgregatlion Reason for continuing Continuing Segregation ns uton rov ?em Idenh?cauon No. a pp a Segregation Regional Approval 24-Jan?14 Reason for Current Segregation: 'Setect length of time: 30 Days Reason: Inmate ls segregated at his YES No Own Request own request claims to tear Other: safely on all units: - Date Released: Review Completed On: 21-Aug-14 Approved By: PERKINS, Jamie Total of Days in Sag: Tltle: Sergeant Signature 22-Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate remains segregated YES NO Medical because he is possible Other-2 "Special Needs" and Is unable Date Released: to function on a regular itvin 04-Nov-14 unit. -I Review Completed On: 21-Aug-14 Approved By: PERKINS, Jamie Total it of Days In 899: Title: Sergeant 105 Signature 2 Report Summary Printed: Page 12 of 1s - 5.21 (1 - 001030 Ontario '30 Day Segregation Report Summary 5CE Region Central Region Institution Name: Toronto East Detention Centre Month Ending I Year Aug 2014 I Continuing Segregation Reason for continuing Continuing Segregation Se roval . . - - . . . Name (Last, lrst, Middle) thft?fegregated gregauon App Institutional Approval Segregation Regional Approval Client identi?cation No. - 27-Apr-14 Reason for Current Segregatton: Select length of time: 30 Days Reason: Inmate Is fonsldered SNU and YES NO - 7 una leto unction one re ular - Inmate Is In need of Protection omen m" 9 Date Released: 12-Sep-14 Revlew_Completed On:_ . 25-Aug-14 Approved By: HOWES, Robert Total II 01' Days In Seg: Title: Sergeant 138 Signature 10-Jun-14 Reason for Current Segregation: Select length oi time: 30 Days Reason: Special Needs lnmate- NO Inmate is in need of Protection omen Ear? ("mum 0" a Date Released: 20-Aug-14 Review Completed On: I - 09-Aug-14 Approved By: HOWES. Robert Total ii! of Days _in Seg: Title: Sergeant 71 I Signature 044un-13 'Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate tears all_ units and . YES El N0 Inmate Is In need of Protection omen ?Shes to "imam seg'egmmn Date Released: Review Completed 0n: 09-Aug-14 Approved By: HIDWES. Robert Total of Days In Seg: Tille: - Sergeant Signature . . Dale Report Summary 521 (1) - Page 11 at 19 001031 Kg: 30 Day Segregation Report Summary . Ontario 50w Region Institution Name: Month Ending I Year Central Reglon Toronto East Detention Centre Aug 2014 Name (Last Firsl Middle) Date Segregated Segregauon Approval Continuing Segregation Reason for continuing Continuing Segregation - I - Institutional Approval Segregation Regional Approval Client No. WY . I . 05-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: anate re?nalins segrlelggited YES NO I . . . - ecause "spec a eeds" . Inmate Is Ill need of Protection omen and is "Mm ?menu? on a I Date Released: regular living unit. 12-Aug-14 Review Completed 0n: 05-Aug-14 - Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant '38 Signature 20-Apr-14 7 Reason for Current Segregation: Select length oi time: 30 Days Reason: Inmate Is ?Sfecial Needsunable to uncllon on a Inmate Is In need of Protection Other: regular "my un?- Dete Released: 12-Sep-14. Review Completed On: 20-Aug-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 145 Signature Date Report Summary Printed: Page 17 of 18 5.21 (1 001032 y? . Ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year ZAE Central Region Toronto East Detention Centre Aug 2014 . . - Continuing Segregation Reason for continuing Continuing Segregation Se re ated Se re ation A rovai . . . ?awe (Last' F'rst' M'd I (23mg )9 9 pp Institutional AppmVal Segregation Regional Approval Client identi?cation No. WY . 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains segregation due to YES No Ins'im?onal Security institutional security- Please . Other: see 5 day review reports Date Released: . 20-Aug?14 Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant I 49 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Continue {with current YES No i . segregation plan. High Pro?le Own Request Other: Case_ Date Released: Review Completed On: 09-Aug-14 Approved By: HOWES. Robert Total of Days in Sag: Title: Sergeant Signature 18-Jun-14 Reason for Current segregation: Select length of time: 30 Days Reason: inmate remake; segregate? at YES No Misconduct (Pending Adjudication) Other: ms 9 3 Date Released: 06-Dec-14 Review Completed 0n: 20-Aug-14 Approved By: PERKINS. Jamie Total ill of Days in Sag: Title: Sergeant 171 Signature Date Report Summary Printed: A 5.21 (1 V- . ff? Ontario 30 Day Segregation Report Summary . 2 AE Region Institution Name: Month Ending I Year 1 Central Region Tor0nto East Detention Centre Aug 2014 Name (Last. First. Middle) Date Segregated Segregation Approval Fog?iqyingliegregatlion Reasgn for ?{P'mumg Cmunumg Segrega'ion I ns rona pprova egrega ion Re ional A roval Client Identi?cation No. (ded?WW) 9 pp 05-May-14 Reason for CurrentSegregation: Select length oitime: 30 Days Reason: inmate remains segregated et YES No lnsmuuonal Secumy omer his own request. Callm_s to fear - sader on the regular Irving 7 - Date Released: unlls. 29-Nov-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie I 'Total it of Days in Seg: Title: Sergeant 208 Signature 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Own request- Fears for his YES No Own Request Other. - solely on all units Date Released: Review Completed On: 09-Aug-14 Approved By: HOWES. Robert Total it of Days in Seg: Title: Sergeant Signature 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: High Pro?le Cese- Own YES No - Institutional Security Other. Raqw?i" "my" - segregation. Fears for his Date Released: safety Review Completed On: I 09-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature - - t, Date Report Summary Printed: I Page1of 1e s.21(1) 001034 Ontario 30 Day Segregation Report summary Institution Name: 5CE Region Month Ending I Year 7 Central Region Toronto East Detention Centre Aug 2014 - Name (Last. First. Middle) Date Segregated Segregation Approval Reasson for con?rming conunf?ng Segregation Client Identi?cation No. - . ns Iona pprova ?egregatlon Regional Approval 23-Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate ls segregated because YES I NO . Medical ha is previous "Special Needs" - Other: and is unable to function on a regular "Ving un". 13-Sep-14 . Review Completed 0n: . i 22-Aug-14 Approved By: PERKINS, Jamie Total 01 Days in Sag: Title: Sergeant 52 - - Signature Date Report Summary Printed: Pass 13 of 15 3.21 (1 001035 Ontario 30 Day Segregation Report Summary 3 I Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 'ame (Last. First. Middle) Date Segregated - Segregation ApprOval Coagglig?gl?gfgva?llon lient identi?cation No. (mm?dd?VWVi - 31-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate rergalns to be - YES No - segregate at his own request. Inmate Is in need of Protection Other: Inmate ls unable to function on Date Released: 3 regular living unit- 20-Sep-14 Review Completed 0n: 28-Aug-14 Approved By: PERKINS. Jamie Tolal of Days In Seg: Title: Sergeant 51 Signature - 5.1 3 Report Summary Printed: 521(1) Page 14 or .18 001036 a. Ontario 30 Day Segregation Report Summary Institution Name: 50W Redion Month Ending I Year Central Region Toronto East Detention Centr Aug 2014' . te Se re ated Se re ation A roval Continuing Segregation Reason for continuing Contlnulng segregation Name (Lash Firs" [3:1,de )9 9 pp Institutional Approval Segregatlon Regional Approval Client Identification No. WW - I . 02?Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate :5 Spleclal Needs trend YES NC El - cannot unct on on a regu ar - lnmete ts in need of Protection omen Inmate "mg uni! Date Released: - Review Completed On: 01-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 29-May-14 Reason for Current Segregation: Select length of llme: 30 Days Reason: Inmatels special needs and YES [3 No Medical cannot function on a regular Other: unit Date Released: 09-Nov-14 Review Completed On: 01-Aug-14 Approved By: HOWES. Reberl Total all of Days In Seg: Title: Sergeant 164 - Signature 30-May514 Reason for Current Segregation: Select length oltlme: 30 Days. Reason: Segregated on Inmates own YES Medical Other: . request I . Date Released: oe-oee?14 Revlew.Compleled On: 01-Aug-14 Approved By: HOWES. Robert Total of Days ln Seg: Title: Sergeant 193 Signature Date Report Summary Printed: - 521(1) Page 15 0t 13 . 001037 ??}Ontario 30 Day Segregation Report'Summary 2C Region Institution Name: - Month Ending [Year 5 . Central Region Toronto East Detention Centre Aug 2014 . . - - Continuing Segregation Reason for continuing Continuing Segregation 8 Se re ation A roval . . Name (LasL First M'ddle) 9 pp institutional Approval Segregation Regional Approval Client Identi?cation No. . 62-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains in ?segregation due his aggress behav our Misconduct (Pending Adjudication) Other: inwards m" and Omar Imam Date Released: 24-Sep-14 Review Completed On: 01-Aug-14 Approved By: HOWES, Robert Total of Days in Sag: Title: Sergeant 84 Signature 02-Jul-14 Reason for Current Segregation: Select length oi time: 30 Days Reason: Continues to be In segregation YES No d- I . on medical observation '3 Other: Date Released: 15-Aug-14 Review Completed 0n: 01-Aug-14 Approved By: Total #_ol Days In Seg: Title: Sergeant 44 Signature I 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Sewing misconducti?reiusin to trans or out. Misconduct (Pending Adjudication) omen mma?egwm no! 90 any Omar Date Released: institution I 06-Aug-14 Review Completed 0n: . 01-Aug-14 Approved By: HOWES, Robert Total of Days In Seg: Title: Sergeant 35 Signature 5.1 Date Report Summary Printed. 521 (1) '30 Day Segregation Report Summary - Ontario. - - 50E Region Institution Name: Month Ending [Year - Central Reg?t Toronto East Detention Centre Aug 2014 Name (Last First Middle) Date Segregated Segregation Approval Con?m?ng segregati?m Reason for ??Pli""i"9 Segregation I Institutional Approval Segregation . Regional Approval Client Identi?cailon No. m" 15-Jul-14 - Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is Special Needs. YES No [3 Own Reques? Inmate can not function on Olha? - regular unit at this time Date Released: A Review Completed On: 14-Aug-14 . Approved By HOWES. Robert Total of Days ln.Seg: Title: . Sergeant Signature 03-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregated because YES NO he is ?special Needs" and is Inmate is in need of Protection omen unable to function on a regular Date Released: Mus unil- 12-Aug-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 59 Signature 08?Jul-14 Reason for Current Segregation: Select iength of time: 30 Days Reason: Inmate in sonsidered as YES NO Special Needs and is unable to - inmate Is in need of Protection omen I funcuon on a regular Inmate Date Released: living unit at this time. 12-Aug-14 Review Completed 0n: 07-Aug-14 Approved By: HOWES, Robert - Total of Days in Seg: Title: Sergeant 35 . Signature . 5.21 (1) Date Report Summary Printed: Page 10 of ta 001039 . Ontario 5CE 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 . . Continuing Segregation Reason for continuing Continuing Segregation irs . Middle Date Se re ated Se re alion A roval . . . - . Name (Last. (maid 9 )9 9 9 PP lnsmuuonal Approval Segregation Reglonal Approval Client identi?cation No. ?I?m 02~May-1fi Reason for Current Segregation: Select length of time: 30 Days Reason: lnmalels spgacial needs apd YES No Inmate is in need of Protection other; $305.13? on on a rag? at Date Released: 14-Nov-14- Review Completed 0n: 01-Aug-14 Approved By: HOWES. Robert Total ill of Days in Sag: - Title: Sergeant 196 Signature 30-May-14 Reason for Current Segregation: Select length of lime: 30 Days Reason: inmate is special needs and YES NO Medical cannot lucllon on any other Other: living unit Date Released: 12-Sep-14 Raylew Completed 0n: - 01-Aug-14 Approved By: Total ii of Days in Seg: - Title: Sergeant 105 Signature 04-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregelgd [13:33:39 YES No - he is ?Special Nee s" an Inmate Is in need of Protection omen unable to function on a mgmar Date Released: living unit. 08-Oct-14 Review Completed on: 05?Aug-14 Approved By: PERKINS. Jamie Tolai of Days In Seg: Title: Sergeant 96 . Signature Date Report Summary Printed: Page 9 or 18 5.21 (1 001040 Ontario 2C- Region Central Region Institution Name: Toronto East Detention Centre .Aug 2014 Month Ending I Year 30 Day Segregation Report Summary Continuing Segregation Reason for continuing Continuing Segregation 'd re ated Se re ation A roval . . . Name (Lasl' Flml' M. die) ?gs? )9 - 9 pp institutional Approval Segregation Regional Approval Client Identi?cation No. WV - . 21-Jul-14 Reason for Current Segregation: Select length or time: 30 Days Reason: Inmate remains segregated for YES NO Medical 0m medical observation. er: Date Released: 12-Sep-14 Review Completed On: I 20-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 53 Signature 09-Sep-13 Reason for Current Segregation: Select length at time: 30 Days Reason: Medical Observation- - YES NO [3 Media! Requires medical equipment . Other: that cannot be placed on a unit Date Released: . 20-Aug-14 Review Completed On: 09-Aug-14 Approved By:. HOWES. Robert Total of Days In Seg: Title: Sergeant 345 Signature 25-Nov-13 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate is a Crown Witness YES NO Own Re "est and unable to live on a normal I ?1 Other. Inmate livingunit - Date Released: 16?Oct-14 Review Completed On: 25-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 325 Signature 1 .1 Date Report Summary Printed: 321(1) P899 3 0t 1" 001041 . Er? Ontario 30 Day Segregation Report Summary 2G I I Region Month Ending I Year . Institution Name: Central Region I Toronto East Detenti0n Centre Aug 2014 - . . - Continuing Segregation Reason for continuing Continuing Segregation ated Se re ation A roval . Nam-e (Last' FlrsIt' M'ddl ?rmsegr )9 9 pp Institutional Approval Segregation - Regional Approval Client identi?cation No. 02-Jul-14 Reason for CurrentSegregation: Select length of time: 30 Days Reason: InmateIs needs and YES No - cannot uncl on on a regular I inmate is in need oi Protection Other: Inma?e living unit Date Released: 09-Oct-14 Review Completed On: . I 01-Aug-14 Approved By: HOWES. Robert Total oi Days in Seg: Title: Sergeant 99 Sbnmum . I 02-Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate continues to remain YES - No . segregated because at I I Misconduct (Pending Adjudication) Other: . behavioun Several outslandmg Date Released: criminal charges of threaten 246ep44 death towards staff. Review Completed On: 28-Aug-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 8?4 Signature 29-Jul~14 Reason for Current Segregation: Select length of time: 30 Days Reason: lnmg1915"SpeclalNeed5"and YES El NO . Medical is unable to function on a Other: regular living unit at this time. I Date Released: 02-Oct-14 Review Completed 0n: 28-Aug-14 Approved By: PERKINS. Jamie Total of Days in Sag: ITitie: Sergeant 65 1 - Signature 3 P. Page'lol? 19 me an ummaw nne: 5.21 (1 001042 Ontario 30 Day Segregation Report Summarv ZAW Region Institution Name: Month Ending I Year . Central Region Toronto East Detention Centre Aug 2014 Name (Last Fir-St. Middle) Date Segregaied Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation institutional Approval - Se re ation Re ional A roval . . . 9 Pp Client Identi?cation No. . I i 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated ror YES NO [3 Medical medical observation. Inmate Other: has a cast on loot. Date Released: 12-Sep-14 Review completed 0n: - 28-Aug-14 Approved By: PERKINS. Jamie Total it of Days in Seg: Title: Sergeant 72 . Signature 04-Jul-14 Reason for CurrentSegregation: Select length of time: 30 Days Reason: Inmate ls segregated an admin YES NO Misconduct (Pending Adjudication) omen ?9 as per Seem? Date Released: 16-Aug-14 Review Completed On: 05-Aug-14 Approved By: PERKINS. Jamie Total it ol'Days in Seg: Title: Sergeant 43 . Signature 18-Jun-14 Reason for Current Segregation: Select length at time: 30 Days Reason: lnmate remains segregated YES No Medical because he requires a medical . I Other: Walker. Date Released: 2T-Aug?14 Review Completed On: 20-Aug-14 Approved By: PERKINS. Jamie Total 01 Days in Seg: Title: Sergeant 70 Signature Data Report Summary Printed: Page 5 or 18 s.21(1) 001043 30 Day Segregation Report Summary FF 7 . Ontario - ZAW, . Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 - Name (Last First Date Segregat?d Segregation Approval Continuing Segregation - Reason for continuing - Continuing Segregation - . - - Insmuuona' Approval . Segregation Reglonal Approval Client Identi?cation No. - 18-Jun-14 Reason tor Current Segregation: Select length of time: 30 Days Reason: anale ralmatnls tin :egjegalion YES E) No . . . I ecause nma 3 av ng - Inmate '5 In "Bed Of Pretecuon Other: getting along with the Date Released: . other P.c inmate. 28-Nov-14 Review Completed On: - - 204mm Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 163 Signature 22-Jun-14 1 Reason for Current Segregation: Select length of time: 30 Days Reason: an319 is segregate; motives YES No . e_ls possible "Spa a eeds" inmate Is In need of Protection Other: and is unable '0 ?menu? on a Date Released: - I - I regular living unit. 16-Oct-14 - . Review Completed On: 21-Aug-14 Approved By: PERKINS. Jamie Total oi Days in Bag: 'Title: Sergeant ?6 . a I Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Remains in segregation on YES [1 No Medic?? - - request of Medical Unit. .- Other: . . Medical Observations - Date Released: - 12-Sep-14 Review Completed On: . 01-Aug-14 Approved By: . HOWES, Roben Total of Days in Seg: Title: Sergeant 72 Signature Date Report Summary Printed: I Page 4 of 13 - 5.2-1 (1) . - - - 001044 )Ontario 30 Day Segregation Report Summary 2AE Region Central Region institution Name: Toronto East Detention Centre Month Ending I Year Aug 2014 Date Segregated Continuing Segregation Reason for continuing Continuing Segregation 'dl .Se re aionA roval . . . ,7 Name (Lash Fm? .d e) pp I Institutional Approval Segregation Regional Approval Client Identi?cation No. WV 18-Jun-14 Reason tor Current Segregation: - Select length of time: 30 Days Reason: Inmate states tlhat he tears his YES Misconduct (Pending Adjudication) omen segregation at ms own mquast Date Released: 11-Dec-14 Review Completed On: - A 20-Aug-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: . Sergeant 176 Signature 21?Mar-14 Reason tor Current Segregation: I Select length of time: 30 Days Reason: Inmate remains segregated at N0 [3 Own Request om his own request. Crown wittnes. . . er: - . Date Released: '27-Aug-14 Review Completed 0n: - 20-Aug~14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 159 Signature 26-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Segregated On inmate's own YES NO Inmate is in need of Protection omen - reques' Date Released: 09-Aug-14 Review Completed On: I 01-Aug-14 Approved Bin HOWES, Robert Total #?of Days in $89: Title: Sergeant 164 - Signature . . Data Report Summary Printed: - Page a 01-13 3.21 (1 001045 .PF Wontario 30 Day Segregation Report Summary 50w Region Institution Name: - Month Ending I Year Central Region Toronto East Detention Centre Aug 2014 Name (Last First Middle) Dale Segregated Segregauon Approval Continuing Segregation Reason for continuing Continuing Segregation - Institutional Approval Segregation Regional Approval Client Identi?cation No. - . 14-Feb-14 Reason for Current Segregation? Select length of time: 30 Days Reason: Special Needs lnmate- YES No . Cannot function on are ular . Inmate is In need of Protection omen 9 Date Released: 12-Sep-14 Review Completed 0n: . - 09-Aug-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 210 Signature 26-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Rea?on: Medical Observation as per YES NO - - Medical Other: - Date Released: 12-Sep-14 Review Completed On: 25-Aug-14 Approved By: HOWES. Robert Total of Days In Seg: Title: Sergeant 48 - Signature 521(1) Date Report Surnmary Printed: Page 18 of 18 001046 Yr? 3?Ontario 30 Day Segregation Report Summary Month Ending I Year ZAW Region Institution Name: . . I Central Region Toronto East Detention Centre Sep 2014 Name (Last. First. Middle) Date Segregated Segregation Approva Continuing Segregation Reason for continumg Continuing Segregation (mm,ch Institutional Approval Segregation Regional Approval Cllent identification No. 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: tanglate remains In sagrlegatlon YES No - a own request. a me to Misconduct (Pending Adjudication) Other: [ear his ?My on a" unus- Dale Released: - 11-Dec-14 Review Completed 0n: . 19-Sep?14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: 1 Sergeant 176 - Signature 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES NO - because he ls unable to get inmate is In need of Protection omen along wuh the cum Pmlediva Date Released: custody Inmate. (Musclingll'lghilng) Review Completed 0n: 19-Sep-14 Approved By: PERKINS. Jamie Total It of Days in Seg: - . Title: - Sergeant 163 Signature 20-Aug-14 Reason lor Current Segregation: Select length oi time: 30 Days Reason: Inmate is "special Needsunable to lunciton on a - - Inmate-ls in need of Protection omen . regular "mg Inmate . Date Released: assaulted Of?cer and remains ?Supervisor Present" staus at this time. Review completed 0n: 19-Sep-14 Approved By: PERKINS, Jamie Total of Days in 339: Title: Sergeant . Signature Data Report Summary Printed: 'ls'21 (1) Page a of 9 Jr: 001047 - Ontario 30 Day'Segregation Report Summary 2AE Region Central Region Institution Name: Toronto East Detention Centre Month Ending I Year Sep 2014 Name (Last. First. Middle) Date Segregated Segregation Approval C?rihn9mg segregauon Reason for copunumg segregation (mink! institutional Approval Segregation Regional Approval Client Identi?cation No. my" I . 07-Feb-14 Reason for Current Segregation: Select length at time: 30 Days Reason: High Pro?le Case? Unable to YES NO Own Request 0m place Inmate within institution - er: Date Released: Revlew'Compieted On: 13~Sep~14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 25-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains in segregation YES No [3 Own Re "85! at his oWn request. Crown - Other: wiltrtess. Date Released: 16-Oct-14 Review Completed On: 24-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title:- Sergeant 325 . Signature 31-Jan-14 Reason tor Current Segregation: Select length of time: 30 Days Reason: High Profile 0333- Unable to . YES NC) El msmuuonal 83cm." find suitable placement within Other: the institution at this time." - Date Released: Review Completed On: 13-Sep-14? Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant . Signature 5.1 Date Report Summary Printed: 521(1) Page 2 of 9 001048 Ontario 30 Day Segregation Report Summary 2AE Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Sep 2014 - - - Continuing Segregation Reason for continuing Continuing Segregation i a A roval .. i Name (Last' [??fegrig seg egauon pp Institutional Approval Segregation Regional Approval I Client Identi?cation No. My? - . 18-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: remains In slegregetllon YES [3 No - - - at own request. nmete Misconduct (Pending Adjudication) Other: being ?gassed by Psyc- Date Released: 06-Dec-14 Review Completed On: - 19-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 171 i I Signature i 05-May-14 Reason for Current Segregation: Select'lenglh of time: 90 Days Reason: Offender has numerous YES [3 NO lnsmuuonal Security Other enemies in this [acuity and iv - cannot go to a General . Population unit and he has Date 23:22:: refused Protective Custody Review Completed 0n: . . 04-Sep-14 Approved By: ELLIS. Lee-Ann . I Total of Days In Seg: Title: Sergeant 208 - Signature 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason; Inmate remains segregated ?est his own, request. Inmate . Other: statement term completed. Date Released: Inmate scared at all units Review Completed On: 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant . Signature 5.1 Date Report Summary Printed: 5.21 (1 Page 1 or 9 5.21 mm i 001 049 in I . &)Ontario 50E 30 Day Segregation Report Summary Region Institution Name: Month Ending [Year Central Region Toronto East Detention Centre Sep 2014 Name (Last. First. Middle) Date Segregated Segregation Approval segregahon Reason for coptmumg segregal'on . . institutional Approval Segregation Regional Approval Client identi?cation No. - _l 05-Aug-14 Reason for Current Segregation: Select length of iirrie: 90 Days Reason: O?ed'nequis ranst'albkla and YES No . Spec at as s. unable to. Inmate Is In need of Protection Other: ?Indian In a regular Date Released: Review Completed On: 04-Sep-14 Approved By: Lee-Ann Total of Days in Seg: Title: Sergeant 38 Signature 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Request to rerpaln In 1 YES [3 NO - segregation- ears a un is inmate is In need of Protection omen Moulding PC. Special Needs . Date Released: Flam? Review Completed 0n: 7 13?Sep-14 Approved By: HOWES. Robert Total of Days In Seg: Title: Sergeant Signature 24-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains in segregation YES NO I: own Re ?85! on his own requesL Fears all Other: units Date Released: - Review Completed On: . 20-Sep?14 Approved By: HOWES. Robert Total of Days in Seg: I Title: Sergeant Signature Data Report Summary Printed: . s.21(1) Page 60! 9 - 001050 Byomario 30 Day Segregation Report Summary ZC Region Institution Name: Month Ending I Year I Central Region Toronto East Detention Centre Sep 2014 - . - Dale Se re aled Se re anon A roval Continuing Segregation - Reason for continuing Continuing Segregation Name (LaSt' ?St Middle) 9 pp Institutional Approval Segregation Regional Approval Client Identi?cation No. I 7 05-Aug-14 Reason tor Current Segregation: Select length'of time: 90 Days Reason: Oftenldeis unstable and YES NO - Speca eeds. Is one a to I mm? Date Released: verbally abusive towards stat! 16-Oct-14 Review Completed 0n: 04-Sep-14 Approved By: ELLIS, Lee-Ann Total of Days in Seg: Title: Sergeant 72 . Signature 15-Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Placed in segregation on own YES No Own Re uesl - request. Unable to ?nd Other: suitable placement Date Released: Review Completed 0n: 13-Sep-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 04-Jul-14 Reason for Current Segregation: Select length of time: 90 Days Reason: Offender ls uunslable and YES No Special Needs. He Is unable to Inmate is in need of Protection omen mono? In a [egular um I Date Released: 08-Oct-14 Review Completed 0n: 04-Sep-14 Approved By: ELLIS. Lee-Ann Total it of Days in Seg: Title: Sergeant 96 - Signature Date Report Summary Printed: Page 6 of 9 - 5.21 (1 001051 EF)Ontario I 2AW '30 Day Segregation Report Summary Region Central Region institution Name: Toronto East Detention Centre - Month Ending I Year Sep 2014 . . . Continuing Segregation Reason for continuing Continuing Segregation die Date Se re ated Se re atton A roval . . . Name (Last Fm?" M'd )9 9 pp Institutional Approval Segregatlon Regional Approval Client Identi?cation No. WW - 22-Jun-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed Special YES No - Needs and is unable to - lnmala '5 ne.9d or Pm?ecuon Olherl . funclion on a regular living unit. Date Released: 16-Oct-14 Review Completed On: . 20-Sep-14 Approved By: HOWES. Robert Total of Days In Seg: Title: Sergeant 116 i Signature 22-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: This inmate requires the use of YES El No Medical - a back brace that cannot be Other: A permitted into a regular unll. I Date Released: 03-Dec-14_ Review Completed Dn: 21-Sep-14 Approved By: HOWES. Robert Total it of Days in Seg: Title: . Sergeant 103 I Signature 26-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated for YES NO Medical medical observation. Other: Date Released: 28-Nov-14 Review Completed 0n: 25-Sep-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 94 Signature . Date Report Summary Pn'nted: s.21(1) Page 001052 I Ontario 30 Day Segregation Report Summary Region institution Name: Month Ending I Year Central Region Toronto East Detention Centre Sep 2014 - Continuing Segregation Reason for continuing Continuing Segregation Se 2 a . . . Name (Lash Flrs_" Mid gr 9 "on Approva? institutional Approval Segregation Regional Approval Client Identification No. . 03-Feb-t4 Reason for Current Segregation: Select length of time: 30 Days Reason: anate segregation YES [3 NO . ecause 0 prev OUS . Insuluuonal secumy Other; Institutional behaviour. Date Released: 01-Oct-14 Review Completed On: . 13-Sep-14 Approved By: HOWES. Robert Total it 0! Days in Seg: Title: Sergeant 240 Signature 25-Jul-14 Reason for Current Segregation: Select length of time: Reason: inmate released trom custody. YES No inmate is in need of Protection omen 22 Date Released: 23-Sep-14 Review Completed On: 23-Sep-14 Approved By: Total of Days in Seg: Title: Sergeant . 60 Signature - 5.21 (1) a Re ort Summa Printed: . Page 9 of 9 33? A l. 001 053 30 Day Segregation Report Summary fir) Ontario 5CW Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Sep 2014 Name (Last First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation (mmwm Institutional ApprOVal Segregation Regional Approval Client identification No. V. 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: YES NO Inmate is in need of Protection Other: I - Date Released: Review Completed On: 29-Sep-14 Approved By: PERKINS. Jamie . Total of Days-In Seg: Title: Sergeant 7 Signature 29-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated - YES NO Medical because he ls possible Oihel?? "Special Needs" and Is unable Date Released; to tuncllon on a regular. living 09-Nov-14 I Review Completed 0n: 01-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 164 Signature 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated YES No . because be Is possible inmate Is in need at Protection Other: "special Needs, and '5 unable Date Remased; to function on a regular living . unit: Revievr Completed On: 01-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant I Signature Data Report Summary Printed: 521 (1) Page a of 001054 Ontario 30 Day Segregation Report Summary Month Ending I Year 5c Region Institution'Name: Central Region Toronto East Detention Centre Sep 2014 Name (Last First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation . Institutional Approval Segregation Regional Approval Client Identification No. 22-Jul-14 . Reason for Current Segregation: Select'length of time: 30 Days Reason: Inmate Is deemed Special YES NO Medical Needs and Is unable to I - Other: function on a regular living unit. Date Released: 04-Nov-14 Review Completed On: 20-Sep-14 Approved By: HOWES. Robert Total of Days in Segz? Title: Sergeant 1 05 Signature 13-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls previous "Special YES NO Needs? and Is unable to Inmate is in need of Protection omen function on a regular ?mg mm Date Released: 04-Nov-14 Review Completed On: 13-Sep-14 Approved By: HOWES. Robert Total of Days In Sag: _Tlile: Sergeant 83 Signature 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated YES NO because he is unable to Inmate is in need of Protection omen . mncuon on a regular Wing Dale Released: unit. Inmate threatens to 14-Nov-14 assault other inmates. Review Completed _On: . :1 3-Sep-14 Approved By: HOWES. Robert Total of Days? in Seg: Title: Sergeant 364 Signature . s.21(1) Data Report Summary Printed: Ontario 30 Day Segregation Report Summary 2c Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 Name (Last First Middle) Date Segregated Segregation Approval - Continuing Segregation Reason for continuing Continuing Segregation de?y I Approval Segregation Regional Approval Client Identi?cation No. WV . I 20-Aug-t4 I Reason for Current Segregation: Select length at time: 30 Days Reason: inmate is ?ep?eciali: Needsunable to unc on on a I inmate Is in need of Protection Other; regular living unit- Date Released: Review Completed On: 20-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Sergeant Signature 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is segregated tor YES No Medical om medical observation. er: Date Released: 14-Nov-14- Review Completed 0n: 20-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 55 Signature 05-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: special needs and is YES El NO una to cope or uncllon on Inmate is in need 01 Protection Other: rag unit Date Released: 16-Oct-14 Review Completed On: 04-Oct-14 Approvad By: HOWES. Robert Total of Days in Sag: Title: Sergeant 72 Signature 5.1 Date Report Summary Printed: Page 6 of 14 321(1) 001056 . 1" 17.37. :Cemaaeegiahj? - ioctzw? ., .: 5x 1-year: gi?N?me?lLan?thir?t: Mggdi?i ,5 - 5 3? ?15I'aftez'isf?g?r'?'gaiggv?f:_i . We}? .Apnrovalz?- Re?issinfq'ricen??uinst" I aic'ontihuin'g semen . - i 7 aRegion'a?lA rover - - - .. 7? :l if": wean?14 gsaegug?ngm til-itirnezv?Sp-?gvs Segrleegate?dtDat?KReteased: -. 11-Dec-14 Review Completed 0n: 20-Oct-14: Approved By: PERKINS. Jamie Title: I Sergeant Total oiDays ln?Seg: 176 ?1 case: If Signature 26?Aug-14 . Date Released: 28-Nov-14 Review Completed On: 25-Oct-14 Reason for Current Segregation: Medical Approved By: HOWES, Robert Title: Sergeant Select length 0! time: 30 Days Other: Total of Days in Seg: 94 Reason: Inmate requires placement in segregation tor medicai purposes at this lime. YES El NO El Signature 29-Jul-14 Date Released: 02-Oct-14 Review Completed On: . 01-Oct-14 Reason for Current Segregation: Medical Approved By: Title: PERKINS. Jamie Sergeant Select length of time: 30 Days Other: Total of Days In Seg: 65 Reason: inmate was involved In a phyical altercation with sag. ceilpartner. YES El NO El Signature Data Report Summary Printed: s.21(1) Page 6 of 14 001057 Qntario 30 Day Segregation Report Summary ZAW . Region . institution Name: Month Ending I Year . Central Region Toronto East Detention Ce'ritre .Qci 2014 Name (Lasi Hm Middle) DaleSegreg-at?d - - segregation Approval Continulng'Segregation Reason for continuing Continuing Segregation - I . institutional Approval Segregation . Regional Approval Client identi?cation No. it 23-Sep-14 Reason for Current SegregatiOn: Select length of time: 30 Days Reason: ?male inmate Is in need of Protection Other: funcuon on a ?ying Date Released: Review Completed 0n: 24-Oct-14 Approved By: HOWES. Robert Total of Days in-Seg: - Title: Sergeant Signature 11-Sep-14 Reason ior_Currenl Segregation: Select length of time: 30 Days Reason: inmate-remains ln segregation YES NO . . for another misconduct Misconduct (Pending Adjudication) omen investigation of staff assault. Date Released: 17-Oct-14 Review Completed On: 14-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 36 Signature 11=Sep-14 Reason for Current Segregation: Select length ol time: 30 Days Reason: lnmatets segregated pending YES No (PBHding Adjudication) omen investigation of assault staff. Date Released: 14-Nov-14 Review Completed On: 14-Oct?14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 64 Signature Date Report Summary Printed: 521(1) Page 4 of 14 001058 ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year 2Aw Central Region Toronto East Detention Centre Oct 2014 Name (Last Firs. Middle) Date Segr?ga?ed' Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation Approval Segregation Regional Approval 4 Client Identi?catlon No. WW - 22-Aug-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate Is segregated as per YES NO - - medical. - Medlcal Other: I Date Released: 03-Dec-14 Review Completed On: 21-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 103 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate request to be YES No as re ated. Hi rolile case. Own Request omen 9 9 9 9 Date Released: Review Completed On: 14-Oct-14 Approved By: PERKINS, Ja?mle Total of Days in Seg: Title; Sergeant Signature 18-Jun-14 Reason for Current Segregation: Select length ottlm'e: 30 Days Reasdn: Inmate Is segregated because YES [3 NO Inmate-is in need of Protection omen ?5 P?eys '?ma'es' Date Released: 28-Nov-14 Review Completed On: 20-Oct-14 By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 163 Signature Date Report Summary Printed: Page a of 14 321(1) 001059 ?yomario 30 Day Segregation Report Summary ZAE Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 :Name (Last First. Middle) Date Segregated Segregation Approval Corltint?ing segregauon Ream" ConunUinQ Segregation . . institutional Approval Segregation RegionaI Approva Client identification No. WV . 18-Jun-14 Reason for Current Segregation: . Select length at time: 30 Days Reason: lnmale is segregated own request. Inmate is Misconduct (Pending Adjudication) omen possima ?special Needs" and . Dale ReIeased; IS unable to Function on a 06-Dec-14 regular living unit at this time. Review Completed On: 20-Oct-14 Approved By: PERKINS, Jamie Total of Days in Seg: Title: Sergeant 171 Signature Reason for Current Select length oitlme: 30 Days Reason: Inmate requests to be YES NO [3 Institutional Security 0mm: ?3 "mm" Date Released: Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant .Signature 17-Sep-14 Reason for Current Segregation: Select length oitime: 30 Days Reason: Inmate is "Special Needs" and YES NO Medical ls unable to tunction on Other: regular living unit at this time. Date Released: - 25-Oct-14 Review Completed On: I 17-Oct-14 Approved By: PERKINS. Jamie Total it of Days in Seg: Title: Sergeant 38 Signature State Report Summary Printed: Page 1 o, 14 - 5.21 (1 001060 30 Day Segregation Report Summary l?y_ - Ontario NI . . Region . InstitutionvName: Month Ending I Year Central Region Toronto East Detention Centre Oct 2014 . - v' -r Continuing Segregation Reason for continuing I Continulng Segregation Name ?Zea? ?F'rSt' M'ddle) ?i?g?d?g?ga'e?t segregahon Approval Institutional Approval Segregation Regional ApprOval Client Identi?cation No. Vt . i i . 12-Sep-14 Reason for Current sagregatlon: Select length of time: R'eas'on: Released to 40 Unlt on this YES NO I IV d?her' - dater Date Released; .14rOCt-14 Revleiivgcompleted 0n: I '14I-Oct-14 Approved By: Total of Days In Seg:_ I . Title: Sergeant I 32 . I . I Signature 5 - . I . - 521(1) 7 we, it 3. J: ateiReport Summary Printeq:_:7, i I Ontario I 30 Day Segregation Report Summary ZAE Region Institution Name: Month Ending I Year Central Region I Toronto East Detention Centre Oct 2014 Name (Lash First. Middle) Dale Segregated Segregation Approval Continuing[S?D?egregatlion Reasgn for continuing Continuing segregation ns i utiona rova regation Re ional A roval Client Identi?cation No; (mm/mm) . pp 9 9 pp 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: lntnate requests to be YES NO segregated. Claims to tear Own Request Other: - safety. Date Released: Review Cornpteted On: I - . 14-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant Signature 29-Sep-14 Reason for Segregation: Select length of time: 30 Days Reason: Inmate ls segregated Bequest Other: in the paetwith a law - - . tome R?teased: If a enforcement of?cet. Fears all . 1__4_ifNov-14 Frills: gr - i .Review??ometeted onzj't 7 . V, - A ?ApgtfoyedkByi; Total it of Days in $69: Title293433314; 953E155 UT - {raw-?NJ 3.125.537 w, Alt-f 1? . Reason:th $952 "n i Selec tin-i .i x- 7' tn? "atelielusle'g to go t0jany,. - unit and}; Into Proteplttie s214(2)(d). .. s.21(1) - 001062 Ontario 30? Day Segregation Report Summary 50W Region Central Region Institution Name: Toronto East Detention Centre Month Ending I Year Oct 2014 Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation Name (Last Firs" Middle) Date segregated Institutional Approval Segregation IA I Iona rova Client Identi?cation No. m) 9 PP I 29-May?14 Reason?for Current Segregation: Select length of time: 30 Days Reason: Inmate Is ?Special Needs" and YES [3 NO [3 Medical a is unable to [motion on a Other: regular living unit. Date Released: 5 09-Nov-14 3 Review Completed On: - 31-0ot714 'Approved By: PERKINS. _Jamie Total of Days In Sag: I Title: Sergeant 164 Signature - 15-Nov-13 Reason for Current Segregation: Select length at time: 30 Days Reason: inmate Is not able to function YES No I . . enregular-Iiving?unils. Inmate Is In need of Protection Other: Threaten '0 assault 0mm, 5 Date Released: 'nmalas- 5 -- 14-Nov-14 I Review completed On: . Approved By: Total of Days In Seg: Title: - Sergeant 364- I Signature a _?p?numlt I I Datef?eie?aaeg: .-: 7- . . Initiate ts? innee'd otPi'otec on -, V: 1? -, . of) time: 30 Days 'Otii?r: 7' 5" Total - ?l Reason; Inmate Is _"Spagtal needfsfahd; is_unabie'to . i; 4? 7_.I_iving unit latittis tirng, 001063 Z?gbntario 50W 30 Day Segregation Report Summary Month Endinu I Year Name (Last. First. Middle) Client Identi?cation No. Date Report Summary Printed:- 5121 mm Region Institution Name: . Central Region Toronto East Detention Centre Oct 2014 I Date Segrega?ed I Segregation Approval Continumg Segregatlon Reason for contInUIng Continuing Segregation Institutional Approval Segregation Regional Approval 13-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is possible "Special YES NO Needs" and Is unable to . Inma?e '5 In need 0' Pm'ecuon Other: iunction on a regular living unit. I Date Released: 04-Nov-14 Review Completed On: 14?Oct-14 Approved By: PERKINS. Jamie Total of Days In 829: Title: Sergeant 83 Signature 11-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is possible "Special YES No P.C.lSpecIaI needs Other, Feeds and Is unable to . uncilon on a regular living unit. Date Released: 24-Oct-14 Review Completed On: 14-Oct-14 Approved By: PERKINS, Jamie Total of Days In 369: Title: Sergeant 43 Signature 29-Sep-14 Reason for Current Segregation: Select length at time: 30 Days Reason: inmate is grinsldered Special YES NO - . . Needs an unable to Inmale '5 In need ?fpr?1ecmn Other: function on a regular unit. Inmate would b9 able to comply with unit rules Review Completed 0n: 29-0ci~14 A Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 58 Signature 5.1 5.21 (1 Ontario 30 Day Segregation Report Summary Region Institution Name: Month-Ending I Year 50E Central Region Toronto East Detention Centre Oct 2014 Name (Last First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation institutional Approval . Segregation Regional Approval Client identi?cation No. WV - . I 04-Jul-14 I Reason for Current Segregation: I Select length of time: 30 Days Reason: is special needs and oop'e or function on inmate I5 In need of Protection omen - rag unit Date Released: - 08-Oct-14 Review Completed On: . 04-Oct-14 Approved By: HOWES. Robert Total of Daysin Seg: Title: 7 Sergeant . 96 Signature 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls possible-"Special No own Ra ?est Needs" and Is unable to . Other: function on regular living unit. Date Released: Review Completed 0n: 14-Oct-14 Approved By: PERKINS. Jamie Total ll of Days in Seg: Title: Sergeant . Signature 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is "Special Needsunable to lucntlon on a inmate is In need of Protection omen Ingmar ?mg ?nu. Date Released: Review Completed On: 7 - 14-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant Signature Date Report Summary Printed: 521(1) Page 11 of 14 001065 Ontario 5CE 30 Day Segregation Report Summary Region Central Region Institution Name: Toronto East Detention Centre Month En'ding [Year Oct 2014 Data Report Summary Printed: Name (Last. First. Middle) Date Segregated Segregation Approval segregal'on Reason commu'ng segregation a . Institutional Approval Segregation Regional Approval Client Identification No. WY - 02-May-14 Reason for Current Segregation: Select length oi time: 30 Days Reason: Inmate ls 'Speclal Needsunable to unction on a Inmate Is In need of Protection Other: - regular [Mng mm Date Released: 14-Nov-14 Review Completed On: 31-Oct-14 Approved By: PERKINS, Jamie Total ot Days in Seg: Title: Sergeant 196 Signature 30-may-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated at his YES NO - 7 Medical own request. Inmate ls unable Olheri to function on a regular living Date Released: unit at "1?3 time. 09-Dec-14 Review Completed On: 31-Oct-14 Approved By: PERKINS. Jamie Total it of Days in Seg: TlIle: Sergeant -193 Signature 03-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is Special Needsunable to function on a inmate Is In need of Protection omen - ?mg - Date Released: 15-Nov-14 Review Completed On: 08-Oct-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 68 Signature 521(1) Page 10 of 14 001066 Ontario 30 Day Segregation Report Summary Region Central Region Institution Name: Toronto East Detention Centre 0t! 2014 Month Ending I Year Name (Last. First, Middle) Date Segregated Segregation Approval - Continuing Segregation Reason for continuing - Continuing Segregation Institutional Approval Segregation Regional Approval Client Identi?cation No. (mm?dd?Wl 02-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: gamete ls possiblegslaeclai YES NO eerie" and is une is to Inma?e Is In Head or Prolacuon Olheri function on a regular living unit. Date Released: 14~Nov?14 Review Completed On: - . 01-Oct-14 Approved By: PERKINS. Jamie Total oi Days in Sag: Title: Sergeant 196 - Signature 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains in segregation - YES No Medical because he is "Special Needs? Other: and Is unable to function on Date Released: regular living unit. Review Completed On: - I 01-Oct-14 Approved By: PERKINS. Jamie Tolai of Days in ?S?eg: Title: Sergeant Signature 30-Aug-14 Reason [or Current Segregation: Select length of time: 30 Days Reason: Inmate ls "Special YES No . . Needs" an ls unable to Inmate '5 need Of Pmlecnon Other: function on a regular living unit. Date Released: 09-Nov-14 Review Completed On: 31-Oct-14 Approved By: PERKINS. Jamie Total ii of Days In Seg?. Title: Sergeant 71 Signature 521(1) Pages t14 r'n - 0 Date Report Summary 001067 Ontario 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year 5CE Central Region Toronto East Detention Centre Oct 2014 - Continuing Segregation Reason for continuing Continuing Segregation Se re ation A roval . . Name (Lash Middle) 9 pp Institutional Approval Segregation Regional Approval Client Identi?cation No. 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is possible "Special YES NO Own Re ues? Needs? and Is unable to Other: function on a regular unit. Date Released: Review Completed 0n: 05-Oct-14 Approved By: I PERKINS. Jamie Total it of Days in Seg: Title: Sergeant Signature 22-Jul-14 Reason for Current Segregation: Select length at time: 30 Days Reason; Inmate Is possible "Special YES NO [3 Medical Needs" and Is unable to Other: function on a regular living unit Dale Released; 8 time- 04-Nov-14 I Review Completed On: 1 20-Oct-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 105 Signature 24-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate remains segregated el YES No own Re "est his own request claims to tear Other: safety on all units. Date Released: Review Completed lOn: 20-Oct-14 Approved By: PERKINS. Jamie Total ii! of Days in Seg: Sergeant I Signature 7. 5.21 (1 Date Re ort Summary Printed: Page a or 14 001068 Ontario 26 30 Day Segregation Report Summary Region- Central Region Institution Name: Toronto East Detention Centre Month Ending I Year Oct 2014 . . - - Continuing Segregation Reason for continuing Continuin Se re ation Midd Dale Se re ated Se re ation A roval . . 9 9 9 Name (LastInstitutional Approval Segregation Regional Approval Client Identi?cation No. WW . . 19-Sep-14 I Reason for Current Segregatlon: Select length of time: 30 Days Reason: Inmate remains In segregatlen YES [3 NO Me'dlcal on medical onservetlon. . Other: . 'Date Released: Review Completed On: - 20-Oct-14 Approved By: PERKINS. Jamler Total of Days In Seg: Title: Sergeant 7 Signature 13-Sep?14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls ADMIN say and segre ated on I Misconduct (Pending Adjudication) omen assaian Date Released: 04-Nov-14 Review Completed On: 14-Oct-14 Approved By: PERKINS. Jamle Total it of Days In Seg: Title: Sergeant 52 Signature 28-Aug-14 Reason for Current Segregation: Select length ottlme: 30 Days Reason: Inmate Is ?Special Needs"and YES NO Medicat - Is unable to function on a Other: regular living unit. Inmate ls Date Released: - also segregated at his own I request. Review Completed On: 31-Oct-14 Approved Bin PERKINSI Jamie Total of Days In Seg: Title: Sergeant . Slgnature Date Report Summary Printed: s.21(1) Page 7 of 14 001069 v- Ontario 2C 30 Day Segregation Report Summary Region Institution Name: Toronto East Detention Centre Month Ending I Year Nov 2014 Name (Last. FirstI Middle) Central Region Continuing Segregation Reason for continuing Continuing Segregation Date Se re ated Se re ation A rovai . . . . )9 9 pp - institutionallApproval Segregation Regional Approval Client Identi?cation No. - - . 26-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segreg?led for YES NO CI Medical 0m . .medlcal reasons. er: Date Released: 28-Nov-14 Review Completed 0n: 24-Nov?14 - Approved By: PERKINS. Jamie Total of Days In Sag: Title: Sergeant - 94 Signature . . 20-Aug-14 Reason for Current Segregation: Select length?of time 30 Days Reason: Inmate isspeclal needs and YES NO - cannot be placed in a regular inmate is in} need of Protection omen inmate living mm as he will be . Date Released: unable to function. 'Review Completed 0n: 20-Nov-14 Approved By: HOWES. Robert Total of Daysln Seg: Title: Sergeant I . Signature 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: lnrnalels "Special Needs" and YES NO - is unable to iunciton on a Inmate is in need of Protection Other: [egular living unit Date Released: Review Completed On: . 13-Nov-14 Approyed By: PERKINS, Jamie Total it of Days in Seg: I Title: Sergeant Signature 5:21 (1 Date Re ortSumma Printed: P399 5 o, 10 9 001070 Ontario 30 Day Segregation Report Summary 5CE Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Nov 2014 . I Name (Last First Middle) Date Segregated Segregation Approval Con?rming segregation Reason for con?nl'ing Conti?Ui?Q Segregation - Institutional Approval Segregation Regional Approva Client Identi?cation No. . WW . 28-Aug-14 Reason for Current Segregation: Select length of time: 30 Days Reason: lnmale has been deem" YES NO Date Report Summary Printed: Date Released: Review Completed On: Medical Other: "Special Needs" and Is unable to lunction on a regular living unit. '28-Nov-14 Approved By: - PERKINS. Jamie Total of Days In Seg: Title: Sergeant Signature 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Elmng unabe to - Inmate Is In need of Protection omen. function on a regular living unil- Date Released: 15-Nov-14 Review Completed Qn: 07-Nov-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant 53 Signature 08-Sep=14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is possible "Special YES No Own Re "est needs" and Is unebte to I Other: function on a regular living unit. Date Released: . Review Completed On: 07-Nove14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant a Signature 5.1 Pagesof 10 001071 a V- Er? Ontario ZAE Region Central Region Institution Name: Toronto East Detention Centre Nov 2014 Month Ending i Year 30 Day Segregation Report Summary Name (Last. First. Middle) Date Segregated . Segregation Approval ?gmm?aglsigfogglm" to a a Client Identi?cation No. ('T'm?dd?wm 9 pp 18-Jun-14 Reason for Current Segregation: Select length of time: 30-Deys Reason: Inmate continues In YES NO Own Re "est . segregation as he refuses to Other: leave. Fears for safety and Date Released: there Is no area to proper 06_Dec_14 place him vrhere he feels sale. Review Completed On: 20-Nov-14 Approved By: HOWES. Robert Total of Days in Sag: Title; sergeant 171 Signature 05-May-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls segregated al'hls YES El NO Institutional Security Other: request Date Released: I 29-Nov-14 Review Completed 0n: . 03-Nov-14 Approved By: PERKINS. Jamie Total it of Days in Seg: TilIe: Sergeant 208 . Sig nature 31-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is segregated at YES NO Institutional Security Other: Pmme- Date Released: Review Completed On: 13-Nov-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant Signature 3.1 10 Date Report Summary Printed. 5-21 (1) a9? 0 5.21 mm 001072 figomario 2AW - 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Nov 2014 Name (Last. First, Middle) Date Segregated Segregation Appr0Val coalinyingls?gregatjon . . . eglona rova Client Identification No. (mm?dd?Vm? pp 18-Jun-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate requests Segregation. YES No own Requesl I Other: Fears for safety - Date Released: 7 -1 1-Dec?14 Review Completed On: - 20-Nov-14 Approved By: HOWES, Robert Total of Days In Seg: Title: Sergeant. 176 Signature 18-Jun-14 I Reason for Current Segregation: Select length ot?llme: 30 Days Reason: Inmate cannot get along with YES No . . . . other PC inmates. Continues A I Inmate is In need of Protection omen '0 pick ?ghts and preys on Date Released: them. Inmate Is poss SNU 28-Nov-14 Review Completed-On: 7 - 20-Nov-14 Approved By: HOWES. Robert Total of Days in Seg: 'Tille: Sergeant 163 Signature 22-Aug~14 Reason tor Current Segregation: "Select length of time: 30 Days Reason: Requires the use of a back YES No M?dical I brace that cannot be permitted Other: In any at the Inmate living units Dale Released; due to the materials that It Is I 03-Dec314 burlt of. Review Completed 0n: 20-Nov?14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant 103 Signature 5.21 (1 Dale Report Summary Printed: 3 1? re 001073 . ff"? Ontario 30 Day Segregation Report Summary 53w Region Institution Name: Month Ending I Year . . Central Region Toronto East Detention Centre Nov 2014 Name (Last First Middle) Daggegregaled Segregation Approval Continuing Segregation Reasongfor continuing - Continuing Segregation Wad, - -) - Institutional Approval Segregation Regional Approval Client Identification No. my 02-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Lnrqal?sis silglfaeatgd bezalusa YES -NO as" peca ee s"an 3 Inmate '5 "Bad or Pm'ewon Other: unable to function on a regular Date Released:_ Revlew Completed On: I - 28-Nov-14 Approved By: PERKINS. Jamle Total of Days In Seg: Title: Sergeant Signature 03-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Ilnmete Is ?Special Needs? and YES No - unable to unc on on a Inmate Is In need of Protection? -- omen regular "my um Date Released: 09-Nov-14 Review Completed On: 03-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 37 Signature 23-Sep-14 Reason tor Current Segregation: Select length ol'time: 30 Days Reason: Inmatelis ?Special Needs' and YES No . Is unal: to unct on on a Inmate IS In need of Protection omen regular living mm. Date Released: Review Completed 0n: 24-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 5.21 (1 Date Report Summary Printed: Page 10 of 10 001074 Ontario 30 Day Segregation Report Summary Month Ending I Year 50w Region Institution Name: Central Region Toronto East Detention Centre Nov 2014 Name (Last, First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continumg Segregation . . Institutional Approval Segregation Regional Approval Client identi?cation No. in? - 15-Nov-13 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate was moved on this YES NO Inmate is In need of Protection omen . Date Released: 14-Nov-14 Review Completed On: 13-Nov-14 Approved By: PERKINS. Jamie Total oI Days In Seg: Title: Sergeant - 364 Signature 17-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is deemed as Special YES NO Medical Needs and Is unable to cope Other: or function on a regular Inmate Date Released: living unit Review Completed On: 17-Nov-14 Approved By: HOWES. Robert Total of Days in 889: Title: Sergeant Signature 24:0cl-14 Reason for Current Segregation: Select length of time: 30 Days Reason: ?Special Needsuric ion on a Inmate is In need oi Protection omen mum Mg "nu. Date Released: Review Completed On: 24-Nov-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature Date Re ort Summa Printed: Page 9 of 10 I sa21(1) - 001075 Ontario 30 Day Segregation RepOrt Summary 5CE Region institution Name: Month Ending [Year Central Region Toronto East Detention Centre Nov 2014 I iddle Dam S-e re ate Se re anon A "we" Continuing Segregation Reason for continuing Continuing Segregation Name (Last F'rs} M. )9 9 pp Institutional Approval Segregatlon - Regional Approval Client Identi?cation No. 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is ?Special Needs" and YES No Own Re uesi ls unable to function on a 1 Other: reguiar living unlt. Date Released: - Review Completed On: 13-Nov-14 Approved By: PERKINS. Jamie Total of Days in 899: Title: Sergeant Signature 17-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls possible "Special YES NO - . . needs" and ts unable to Inmate Is In need of Protection omen mum on a regular "mg mm Date Released: 3? ?1?3 ?m3- 20-Nov-14 Review Completed 0n: 17-Nov-14 Approved By: PERKINS. Jamie Total 01 Days in Sag: Title: Sergeant 64 Signature 22-Oct-14 Reason for Current Segregatlon: Select length of time: 30 Days Reason: Inmate is special needs and YES [3 No remains in segregation as he Other: ls unable to function on a Date Released: regular inmate living unit Review Completed On: 21-Nov-14 Approved By: HOWES. Robert Total 01 Days In Seg: Title: Sergeant . Signature 5-1 4l2lld) 521?) HMBM10 001076 Ontario 30 Day Segregation Report Summary Month Ending I Year 56E Region Institution Name: Central Region Toronto East Detention Centre Nov 2014 03 a" 5 re anon A roval Continuing Segregation Reason for continuing continuing Segregation Name (LaSt' First Middle) Ed e9 9 pp Institutional Approval Segregation Regional Approval Client Identi?cation No. will" I 30-May-14 Reason for Current Segregation: Select length at time: 30 Days Reason: Inmate has been cleared by YES [3 NO Medical psyc. But wants to remain ln . Other: seg. Unable to function on - Date Released: regular unll. 09-Dec-14 Review Completed 0n: . 28-Nov-14 Approved By: PERKINS. Jamie . Total of Days In Seg: Title: Sergeant 193 Signature 31-Oct-14 Reason for Current Segregation: Select length of time: '30 Days Reason: Emails ls "Spatial YES unable to Inmate is In need of Protection when funcuan on a mum mg unit Date Released: - Review Completed On: 28-Nov-14 Approved By: PERKINS. Jamle Total of Days in Seg: Title: Sergeant Signature 24-Jan-14 - Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate tears for safely in all YES NO Own Re u'ast units. Unable to - ?1 Other: place him anywhere Date Released: I Review Completed On: 20-Nov-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature Date Report Summary Printed: 5'21 (1) Page 7 or 10 001077 - EF)Ontario 2AE 30 Day Segregation Report Summary Region Institution Name:. Month Ending I Year . 'Central Region Toronto East Detention Centre Nov 2014 Name (Last, First; Middle) Date'Segregated Segregation Approval ?g?m?gliepggfoa?m Client identi?cation No. ?(mm?dd?myi 7 03-Jan;14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate Is segregated uesl oirirn request. Claims to fear Other: safety on all units. Date Released: Review Completed on: 13-Nov-14 Approved By: PERKINS. Jamie Total oi Days in $69: Title: Sergeant . Signature 11-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate was transferred on this YES NO Misconduct (Pending Adjudication) when Date Released: 14-Nov-14 Review Completed On: . 13-Nov-14 Approved By: PERKINS. Jamie. Total of Days In Seg: Title: Sergeant 64 Signature 07-Feb-14 Reason for Current Segregation: Select length of time: 30 Days Reason: llnmete is segregated at his YES NO Own Re ues? own request and claims that - Other: he tears his safety. Date Released: Review Completed On: ,t - 13-Nov-14 Approved By: Jamie Total ii! of Days In Seg: Title: Sergeant Signature 3.1 Date Report 521 (1) Page 2 or 10 51 001078 ?F>Ontario 30 Day Segregation Report Summary ZANV Ramon I MthEnmnolYew - Central Region Toronto East Detention Centre Nov 2014 . Name (Last. First. Middle) Date segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation . Institutional Approval Segregation Regtonal Approval Client Identification No. WV - . 20-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate continues numerous assaults aga Mtsconducl (Pending Adjudication) omen staff and ongoing mlsconduds. Date Released: 03-Dec-14 Review Completed 0n: 20-Nov-14 Approved By. HOWES. Robert Total ii of Days in Seg: Title: Sergeant 44 Signature 22-Oct-14 Reason for Current Segregation: Select length of time: _30 Days Reason: inmate ts special needs end YES No . . wauld be unable to funcl on on . Inmate ts In need of Protection Diner: 3 regular [male [Mug un? Date Released: 29-Nov-14 Review Completed On: 21-Nov-14 Approved By: Robert Total of Days In Seg: Title: Sergeant 33 Signature 19-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls segregated due to YES NO Medical medical observations but is . Other. also requesting to remain in Date Released: segregation "tears for safety? Review Completed On: 20-Nov-14 Approved By: HOWES. Robert Total of Days In Seg: Title: Sergeant Signature I 3! t3 P'ld 521(1). Pe edof10 ae eor umma rtne: 001079 >Ontario _30 Day Segregation Report Summary Region Institution Name: Month Ending I Year 5CW - - Central Region. Toronto East Detention Centre Dec 2014 Name (Last. First. Middle). Dale Segregated Segregation Approval . Continuing Segregation Reason for continuing Continuing Segregation . Institutional Approval Segregation Regional Approval Client identi?cation No. WV I 18-Nov-14 Reason for Current Segregation: Seiecttength oftime: 30 Days Reason: Inmate ls seggelgated at N0 El . i own request. aims that he I5 inmate is In need of Protection Other: .Specla. hams Date Released: 359955? by Psyc- Review Completed on: - . 17-Dec-14 Approved By: PERKINS. Jamie Total of Days In Seg: Title: Sergeant I Signature 13-Nov~14 Reason for Current Segregation: Select length of time: 30 Days Reasoni. Inmatills "Special Needstrue ion on a Inmate Is In need of Protection omen legular [Mag a 5 Date Released: . Review Completed On: I . 12-Dec-14 Approved By: PERKINS. Jamie Totem oi Days in Seg: Title: Sergeant I II Signature 5.21 (1) Pagesof 9 Date Report Summary Printed: 001080 by. - V>Ontarlo 30 Day Segregation Report Summary Month Ending I Year 2Aw Region I Institution Name: . . Central Region Toronto East Detention Centre Dec 2014 Name (Last irst. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Contlnuing Segregation I . institutional Approval Segregation Regional Approval . Client Identi?cation No. a i 07-Feb-14 Reason for Current Segregation: Select length at time: -30 Days ReaSon: inmate is segregated at his YES NO own request. Fears safety lrom . 0w" Requa? Other: - other oilenders. Date Released: Review Completed On: I 12-Dec-14 Approved By; PERKINS, Jamie Total of Days in Seg: I Title: Sergeant - - Signature 05-Nov-?l4 Reason for Current Segregation: Select length of time: 30 Days Rea'so'n: Inmate ls possible ?Special YES No Own re uesl . Needs? end is in segregation Other: at his own request. Date Released: 12-Dec-14 Review Completed On: . - 05-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 37 . Signature 19-Sep-14 Reason for Current Segregation: . Select length of time: 30 Days Reason: Inmate remains segregated for YES [3 NO Med! 1 . . medical observation. . ca Other: Date Released: Review" Completed 0n: 17-Dec-14 Approved By: PERKINS. Jamie Total it of Days in Seg: Title: Sergeant - - Signature Date Report Summary Printed: 5-21 (1) Page 2 of 9 - . 001 081 . EROntario 30 Day Segregation Report Summary 5cw Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 Name (Last. Firs" Middle) Date Segregated Segrega?on Approval Continuing Segregation Reason for'_continulng Continuing Segregation I - Institutional Approval Segregation Regional Approval Client Identification No. WW 24-Oct-14 Reason for Current Segregation: Select length of time: 530' Days Reason: Inmate is previous "Special I YES NO - - Needs? and requests to rem an Inmate is In need of Protection Other: In segregaum Date Released: Revlevr Completed On: - . 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 02-Jul-14 Reason for Current Segregation: Seleot length of time: 30 Days. Reason: Innletesls segregated because YES NO [3 he s? peclal Needs' and Is inmate is in need of Protection Other: ?name ?mam on a lagular Date Released: liva "mt- Revlew Completed On: I 28-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: . . Title: Sergeant Signature 17-Oct-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls unable to function on YES NO Medical - a regular unit due to special Other: needs and Special Health Date Released: Cafe ?9?19 - Revievv Completed on: 17-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature . Date Report Summary Printed: - Page 7 of 9 - 5.21 (1 001082 - y? 'r I Eigomario 30 Day Segregation Report Summary Month Ending I Year 50w I Region Institution Name: - Central Region Toronto East Detention Centre Dec 2014 I Dale Segregated Continumg Segregation Reason for continumg Continumg Segregation Name (Last, First. Middle) Id same? to? Ap-pro Institutional Approval Segregation Regional Approval Client Identi?cation No. mm . 23-Sep-14 0 . Reason tor Current Segregation: Select length of time: 30 Days' Reason: inmate ls [geviousgisgecial - YES [3 NO - - - ee 3"en suna . Inmate '5 in "Bad 0' Promic'lo" Omar: function on a regular living unit. Date Released: Review Completed On: I . 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant . Signature 05-Nov-14 Reason for Current Segregation: Select length of lime: 30,0ays Reason: Inmate Is_"Speclal Needsunable to function on i lea Oihef: regular living unit. Date Released: Review Completed _On: 05-Dec-14 Approved By: PERKINS. Jamie ?'blal all of Days In Seg: Title: Sergeant . Signature 25-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Emile is YES No El . .. ?ee s'an suna eo Inmate Is in need of Protection Other: ?mum on a regular ?mg mm. Date Released: I Review Completed On: I 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: I Title: Sergeant Signature I 5.1 Date Report Summary Printed: Page a or 9 5.21 001083 . Ontario I - 30 Day Segregation Report Summary Month Ending I Year 2c Region institution Name: Central Region Toronto EastDetention Centre Dec 2014 i Name (Lasli First Middle) Date Segregated Segregalim Approval' Continuing Segregation Reason for contlnuing Continuing Segregation - I . (mm/d - Institutional Approval Segregation Regional Approval Client identi?cation No. My" . 20-Aug-14 Reason tor Current Segregation: Select length oi lime: 30 Days Reason: inmate remains segregated YES No . because 0 two assaults on i Inmate is In need of Protection omen ?an Inmate is. ?so "special Dale'Re'eased; Needs? and is unable to function on a regular living unit. ReviewrCompieied On: 17-Dec-14 Approved By: PERKINS. Jamie Total it of Days in Seg: Title: Sergeant Signature 26-Nov-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is YES [1 No - own request. nmate 6 ng inmate Is In need of Protection omen. "engulfed to TSDC on Date Released; Monday Dec 29 2014. Review Completed On: I 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant Signature 7 15-Jul-14 Reason for Current Segregation: Select length of time: 30 Days Reason: inmate is segregated at his YES No Own Re ?est . . own request. Refuses to leave . Cl Other: - segregation. Date Released: Revievv Completed On: 4 12-Dec-14' Approved By: . PERKINS. Jamie Total ti of Days In Seg: Title: Sergeant 0 Signature 5.21 (1 . 5.21 2 Pageaol' 9 Date Report Summary Printed: 001084 ontario' 30 Day. Segregation Report Summary Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 Name (Last. First. Middle) Date Segregated Segregation Approval segregation Reason for copl'nu'ng com"?an segregation . Institutional Approval Segregation Regional Approval Client Identi?cation No. WW) . 7 22-Oct-14 Reason for Current Segregation: - Select length of lime: 30 Days Reason: Inmate Is deemed as Special YES N0 Medical Needs and Is unable to I Other: function or cope on normal Date Released: Inmate living unit Revlew Completed On: I. - 21-Dec-14 Approved By: HOWES. Robert Total of Days In 899: Title: Sergeant A Slgnature 20-Nov-14 Reason for Current Segregation: Select length at time: 30 Days Reason: inmate ls pdolssibla ";speclal YES No - . ee 5" an unab to I Inmate ?3 new 0' Pwtecuon Other: tuncllon on a regutar living unit. Date Released: . - 29-Dec-14 Review Completed On: . 17-Dec-14 Approved By: PERKINS. Jamie Total 01 Days in Seg: Title: Sergeant 39 Signature 24?Jan-14 Reason tor Current Segregation: Select length of time: 30 Days Reason: Inmate remains segregated 3! YES El NO Own Re ?es. his own requesL Fears his Other: safety on units. Date Released: 7 Review Completed 0n: . 17-Dec-14 Approved By: PERKINS. Jamie Total it of Days in Seg: Title: Sergeant Signature Date Report Summary Printed: Page 6 or 9 5.21 (1 001085 Ontario 50E 30 Day Segregation Report Summary Region Institution Name: Month Ending I Year i . ?33 Central Region Toronto East Detention'Centre Dec 2014 - - . - Continuing Segregation Reason for continuing Continuing Segregation al . . - Name (Lasthirst. Middle) . Segregation Approv lnsmuuonal Approval Segregahon Regional Approved Client identification No. my} . a I 31-Oct-14 Reason for Current Segregation: Select length of time: .30 Days Reason: sulaglragalgd pezarse YES N0 - es" peca ee s?an I Inmate is in need of Rrotection omen I [mama l9 ?menu? on a regular Date Released: living unit. Review Completed On: 28-Dec-14 Approved By: HOWES. Robert Total of Days in Seg: Title: Sergeant Signature 08-Sep-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate ls segifgaied YES El N0 t. ears on ety. Own Request omen "aqua: Date Released: Review Completed On: - - 05-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg:_ A Title: Sergeant Signature 24-Nov-14 Reason for Current Segregation: Select length of time:' 30 Days Reason: inmate is ?osslbiengpteclal YES [3 No - ee s"an is una Inmale '3 In new of Pm'emm" Other: tuncllon on a regular living unit. Date Released: Review Completed On: 24-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant 1 Signature . Date Report Summary Printed: 521(1) Page 4 or 9 ., 001086 ff"? Ontario 30 Day Segregation Report Summary 5CE Region Institution Name: - Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 Name (Last First Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continuing Continuing Segregation 1' Institutional Approval Segregation - Regional Approval Client Identi?cation No. - . 04-Jun-13 Reason for Current Segregation: Select length of time: 30 Days Reason: :nmalzlle Needs? and YES NO suna 9(1an onona Inmate Is In need of Protection Other: regular living um Also Date Released: Inmates on request. Review Completed On: 12-Dec-14 Approved By: PERKINS, Jamie Total ol Days In Seg: Title: Sergeant Signature 19-Nov-14 Reason for Current Segregation: Select length oitlme: 30 Days Reason: Inmate regntallns segregated YES No . because 0 5 prev OUS I Inmate Is in need of Protection omen "spew! News" and is unable - Dale Released; - to function on a regular living unit. Review Completed On: 17-Dec-14 Approved By: PERKINS. Jamie Total of Days in Seg: Title: Sergeant . 7 Signature . 28-Aug-14 Reason?lor Current Segregation: Select length of time: 30 Days Reason: Inmate Is segregated because YES No- Medical 7 he ls "Special Needs" and Is Other: I unable to function on a regular Date Released: living unit. Review Completed On: - 28-Dec-14 Approved By: I-IOWES. Robert Total ol Days in Seg: - Title: Sergeant Signature 521?), Nmsme' - ?t E. 001087 . i Eryomario 30 Day Segregation Report Summary 2AE Region Institution Name: Month Ending I Year Central Region Toronto East Detention Centre Dec 2014 Name (Last. First Middle) Date Segregated Segrega?ion Approval Continuing Segregation Reason tor continuing Continuing Segregation . . Institutional Approval Segregation Regional Approval Client Identification No. . "y - ., 03-Jan-14 Reason for Current Segregation: Select length of time: 30 Days Reason: Inmate is segregated uesl own request. Fears saier at - Other: this lnstution. Date Released: Review Completed On: . . 12-Dec-14 Approved By: PERKINS. Jamie ?T'oiai rr of Days in Seg: Title: Sergeant Signature 04-Nov-14. Reason for Current Segregation: Select length oi time: 30 Days Reason: Inmate Is segregated eihls YES [3 No MBdicaI own request. Callme to have I I Other: medical Issues. - Date Released: - Review Completed 0n: . 03-Dec-14 Approved By: PERKINS, Jamie Total# of Days in Seg: Titlez, Sergeant - Signature 31-Jan-14; Reason for Current Segregation: Seiectiength of time: 30 Days Reason: Inmate is sengegated at his YES No El . own request. ears as ety - Institutional Security Other: because 0? mg? promo . Date Released:. charges. Review Completed 0n: 12-Dec-14 Approved By: PERKINS. Jamie Total oi Days in Seg: I - 1 Title: Sergeant Signature Date Report Summary Printed: s.21(1) Page?t 6r 9 001088 7 Onta?) '0 30 Day Segregation Re rt Summary Region Institution Name: . Month Ending! Year . Central Toronto South Detention Centre August 2014 . Name (Last, First, Middle) Date Segregated Segregation Approval Fo?intl?ing-liegregatrn Reasgn for Cal?linumg Client identi?cation Nb. (mm/MW) ns I Iona pprova egrega Ion egiona pprova May 32014 I . Medical I Misconduct \Approved by: Mr. _Hana?n Name Title: Deputy Hanafin Reason for current Segregation: Yes Select length of time Other: 122 Days Reason: Medical care needs] Assaultive behaviour towards staff and inmates. YES NO l:l Comments: Signature Reason for current Segregation: Yes Reason: Special Needs. inmata YES NO Comments: April 14th. 2014 Medical I th H. I Currently no special needs units - Approved by: Mr. Hana?n ?3 90" eng 0 '.Name Title: Deputy Hana?n open at TSDC. MHAU not open at this time.. Signature May 2014 Administrative - Approved by: Mr. Hana?n Name 8- Title: Deputy Hana?n- Reason for current Segregation: Other: 140 Days Yes - Select lenght of time Other: 94 Days Reason: Protective custody required. No protective custody units at NO El Comments: YES El Signature June 2014 Medical Approved by: Mr. Hana?n Reason for current Segregation: Yes Select length if time Reason: Special Needs inmate. Currently no special needs units open at TSDC. MHAU not open? I YES El NO I: Comments: Name 8: Title: Deputy Hanafin Other; ggbays at this time? . Sign_ature A Reason for current Segregation: Yes Reason: Safety and security of [j 0 July 29 2014 Administrative - Approved by: Mr. Hanafin Name Title: Deputy Hanafin? Select length of time Other: 34 Days the inmate subject to assaulting Correctional Officer staff at previous institution. Signature June 2014 . Medical ApproVed by: Mr. Hana?n Name Title: Deputy Hanafin Reason for current Segregation: Select Answer Select lenght of time Other: 65 Days Reason: Requires placement in Medical-Housing Unit. MH Unit- - at TSDC not open at this time. .YES Signature June 2014 Io.\\l Medical Misconduct Approved by: Mr. Hana?n Name Title: Deputy Hanafin Reason for current Segregation: Select Answer Select lenght of time . Other: 34Days Reason: TSDC medical unit not open at this time. YESE. Signature - - Distribution List: Institution Cepy Records Department, Regional Of?ce magi-bu .. "EC-Elven I 45}in 521(1) . fay: cso SEP 5 20? - v?i?fgill alarm moron I 001039 INSTITUTIONAL SERVICES i 30 Day Segregation \Re.t Summary Region I Institution Name: Month Ending 1 Year a Central Toronto South Detention Centre August 2014 Name (Last. First. Middle) Date Segregated Segregation Approval Reasgn for Client Identi?cation No. . lona pprova egregatlon eglona pprova 030 075-101 (rev. 10/08) July 2014 Reason for current Segregation: Medical Approved by: Mr. Hana?n Name Title: Deputy Hanafin Yes Select length of time Other: 34 Days Reason: TSDC medical unit not open at this time. YES Signature July 2014 Reason for current Segregation: Medical Approved by: Mr. Hana?n Name 8. Title: Deputy Hana?n Yes Select Length of time Other: 53 Days. Reason:_TSDC .medical unit not open at this time YES NO Comments:_ Signature July 2014 Reason for current Segregation: Administrative Approved by: Mr. Hana?n Name 8. Title: Deputy Hana?n Yes Select lenght of time Other: 53 Days Reason: Safety and security of the inmate subject to assaulting Correctional Of?cer staff at previous institution on day of transfer to TSDC. YES NO Comments: Signature - July 2014 Reason for current Segregation: Administrative I Approved by: Mr. Hanafin Name 8. Title: Deputy Hana?n Yes Select length if time Other: 59 Days Reason: High-Risk inmate subject to multiple activations. AYES NO Comments: I Signature July 2014 Reason for" current Segregation: Administration Approved by: Mr. Hanafin Name 8. Title: Deputy Hanafin Yes 60 days Other: Reason: Inmate was released from unit but requested to remain subject to safety and security concerns. YES NO El Comments: Signature July 2014 Reason for current Segregation: Medical and Misconduct Approved by: Mr. Hanafin Name Title: Deputy Hana?n Select Answer Select lenght of time Other: 55 Days Reason: TSDC medical unit not open at this time. Assaultive behaviour toward staffers. - YES NO El Comments: Signature Reason for current Segregation: Approved by: Name Title: Select Answer Select lenght of time Reason: YES El NO Comments: I Other: Signature {l 7 Distribution _List: Institution Copy?Records Department, Regional Of?ce 7 . - - a rwl? - all" . . '7 ll 521(1) SEP 5- 2014 46} 9? ?ll" . I j??j . calm REGION - . SERVICES 001090 f. q. 30 Day Segregation Re! Region Institution Name: Month Ending Year Central Toronto South Detention Centre September 2014 I Name (Last, First, Middle) Date Segregated Segregation Approval coqt'ni?mg segregan-o" Reason for segregat'on . (mm/dd, - Institutional Approval. Segregation Regional Approval Client Identi?cation No. . my . - Reason for current Segregationz' Select Answer Reason: Mental Health issues. YES No comments; July 10, 2014. Admin-Mental Health 60 MHAU not open _at this time. Approved by: D. Hana?n ays Inmate not suitable for Name a Title: Deputy Supt. Other: placement on livmg unit. 7 Signature Reason for current Segregation: Select Answer Reason: IIM segregated to YES NO El Comments: Aug 2, 2014. Admin-Protection of inmate. 60 protect from other inmates." Approved by: D. Hana?n'v 3Y5 Internal placement options being - . reviewed as more un'ts 0 en at Name 8- Title. Deputy Supt Other: Signature Reason for current Segregation: Select Answer Reason: Mental Health issues. YES [2 No [3 Comments; Aug 30. 2014. Misconduct- Assaulted staff. MHAU not open at this time. - Mental Health issues. 30 ays Assaulted staff member with Approved by: D. Hana?n Other bodily ?uids on Sept 19, 2014. Mama 2 Tilla- Q: mt I S gnature - Reason for current Segregation: Select Answer Reason: Involved in group . YES No Comments; Sept 4, 2014. Serving Misconduct/Admin . 30 assault on inmate. Internal i Approved by: D. 'Ha'na?n ays placement options under review. Name 8: Title: Deputy Supt. Other; Signature Sept 4, 2014. Reason for current Segregation: Administrative-Mental Health. Approved by: D. Hana?n Name Title: Deputy Supt Select Answer 30 days 0 Other: Reason: Misconduct for non- compliant behaviour. Mental Health issues. MHAU not open at this time. - YES NO Comments: Signature May 2. 2014. Reason for current Segregation: Administrative . Approved by: D. Hana?n Name Title: Deputy Supt Select Answer Select lenght of. time Other: 150 days Reason: Assaultive lNon- Compliantgbehaviour; Inmate currently on special handling procedures due to assaultive behaviour. YES El NO Comments: Signature Reason for current Segregation: Approved by: Name Title: Select Answer Select lenght of time Other: Reason: YES NO Comments: Signature Distribution List: Institution Copy - Records Department, Regional Of?ce CSD 075-101 (rev. 10/08) 521(1) Nd 001091 ?orists - Region Institution Name: 30 Day Segregation Re,ort Summary Month Ending Year Central Toronto South Detention Centre November 2014 1 Name (Last, First, Middle) Date Segregated. Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation I Institutional Approval Segregation Reg onal Approva Client Identification No. October 7th, 2014 Reason for current Segregation: Administation I Medical Approved by: Ms.? DiNino Name 8. Title: Deputy DiNino Yes Select length of time Other: 31 Days Reason: Mental Health 'concerns and Special Needs inmate. . TSDC does not have medical unit open at TSDC YES NODComments: - I. Signature Reason for current Segregation: 'Yes Reason: Inmate refused transfer YES El No Comments: camber 9th' 2014 Misconduct . . to alternate institution. - - Approved by: Ms. Di Nino eect ?th 0 tlme I Name Title: Deputy Di Nino .Other: 32 Days Signature September 4th, Reason for current Segregation: Yes 7 Reason: Own Request: Safety I YES NO Comments: Name 8. Title: Other: Administration 8 I I and Security concerns if moved 2014 Approved by: Ms. Di Nino ec't eng to "me to a living unit within the Name Title: Deputy Di Nino Other; 67 Dates mSt'tUt'on' Signature Name: Reason for current Segregation: I Yes Reason:' YES No [3 Comments; Approved by. Select length if time Name 8. Title: Other: - . Signature . Name: Reason for current Segregation: Yes Reason: YES No Comments; Approved by: Select length of time Name Title: - Other. 3 . Signature Name: Reason for current Segregation: Select Answer Reason: YES NO [3 Comments: Approved by: Select lenght of_ time Namel& other: Signaturer I Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by. - Select lenght of time Signature . Distribution List: Institution Copy Records Department, Regional Of?ce CSD 075-101 (rev. 10/08) - s.21(1) 4 Map? we 001092 I kOntai?' 0. 30 Day Segregation Re rt Summary" Region Institution Name: Month Ending I Year Central Toronto South Detention Centre November 2014 . .Name (Last, First,>MiddIe) Date Segregated Segregation Approval Client Identi?catiOn No. (mm?dd?m?y) . Reason for current Segregation: Select Answer Reason: Inmate safety and YES 'No [3 comments; September Administration/Inmate Request 8 I I . security. Inmate would not sign 2014 Approved, by: Ms?. Di Nino 9? engt into Part of - Name 8. Title:I_Deputy Di Nino Other: 61LDays placement review process. Signature October 2014 Reason for current Segregation: Medical I Administration Approved by: Ms. Di Nino Name Title: Deputy Di_ Nino? Select Answer Select Length of time- Other: 33-Days Reason: Safety and security of institution, inmate admitted with lClT. TSDC does not have a medical unit open at this time. YES NO El Comments: Signature Name: Reason for current Segregation: Select Answer I Reason: YES No Comments; Approved by. Select lenght of time Name - other: Signature Name: Reason for current Segregation: Select Answer Reason: YES NO El Comments: Approved by. Select length if time Name Title: Other; I - Signature Name: Reason for current Segregation: Select Answer Reason: YES No Comments; 1? a . Approved by. . Select length of time Name Title: Other; . - Signature Name: Reason for current Segregation: Select Answer Reason: YES NO Comments: Approved by. Select lenght of time Name 8. Title: Other; Signature Name: Reason for current Segregation: Select Answer Reason: YES NO Comments: Approved by: Seleot lenght of time . Name Title: Other; - Signature Distribution List: Institution Copy -.Records Department, Regional Of?ce 050 075-101 (rev. 10/08) s.21(1) 10? 001093 I pOntaiaf - I - . I . _3ODaySegregation Re rtSummary Region I Institution Name: Month Ending 1 Year Central Toronto South Detention Centre November 2014 - Name (Last. First, Middle) Date Segregated Segregation Approval I . - Client Identi?cation No. - (Wm?dd?W? . . - Reason for current Segregation: Yes Reason: Medical care needs 1 YES No Comments; May 2014 Administration I Medical I I I - II. Assaultive behaviour towards . I 7 Approved by: 'Ms. Di Nlino . 99? eng 0 staff and inmates: TSDC does Name 8- Title: Deputy Di Nino Other: 192 Days I mt have a med'cal umt Op?n' Signature - - - Reason for current Segregation: Yes . Reason: Medical careneedsl YES No comments; October 2014 Medical I Administration 8 I I TSDC does not have a medical - Approved by: Ms. Di Nino eecyengt 0 "me - unit open. I Name 3ITitlei Deputy Di Nino Other: 31 Days Signature - Reason for current Segregation: Yes - Reason: inmate requested to YES No Comments; October 2014 Administration 1 Inrnate Request 8 I I I II, remain in Segregation citing Approved by: Ms. Di Nino I . I 3 6? tang 0 Safety and Security concerns. Name Title: Deputy Di Nino Other; 32 Days I I Signature Reason for current Segregation: Yes 7 'Reason: Medical care needs] YES No Comments; ,July 2014 Medical Misconduct I I .f I. . TSDC does not have a medical . Approved by: Ms. Di Nino ect en9_ 'me unit open at this time. inmate Name a Title: Deputy Di Nino . Other; 123 Days - assau't've Sta?- . - . 7 - Signature Reason for current Segregation: Yes Reason: Safety and Security YES No Comments; September Administration!Misconduct I I II II. concerns if moved toa living unit 2014 Approved by: Ms. Di Nino? 99?? engt withinthe institution subject to I Name 8. Title: Deputy Di Nino Other; 57 Days Street 'nVOIVement' - . A Signature ,1 Reasonfor current Segregation: Yes - Reason: Medical care needs] YES El NO Comments: September Medical - I I I I. TSDC does not have a medical 2014 Approved by: Ms. Di_Nino eect eng 0 unit open. Name &'Title: Deputy Di Nino Other; 32 Days Signature I Reason for current Segregation: Yes Reason: Inmate requested to YES No D.Comments; {September Administration I I ht I I, remain in Segregation citing I 2014? Approved by: Ms..Di Nino 9 act eng 0 Safety and Security concerns Name Title: Deputy Di Nino Other: 61 Days and refused ORIENTATION. Signature Distribution List: Institution Copy Records Department, Regional Of?050 075-101 5-21?) - . - . Hot001094 Ontar? I: 30 Day Segregation Resrt SuImmary Region Institution Name: . Month Ending I Year Central Toronto South Detention Centre I November 2014 Continuing Segregation Reason forIcontinumg Continuing Segregation ame( as "St M'ddle) segregat'on Approval Institutional Approval Segregation Regional Approval Client Identi?cation No. October 2014 Reason for current Segregationiv Medical . Approved by: Ms. Di Nino I Name Title: Deputy Di Nino Yes Select length of time Other: 34 Days Reason: TSDC does not have a medical unit open at this time. Remains part of the internal placement review process. YES-D NO CI Comments: Signature October 2014 Reason for current Segregation: Medical 1 Administration Approved by: Ms.- Di Nino Name 8. Title: Deputy Di Nino Yes Select Length of time Other: 32- Days Reason: TSDC does not have a . medical unit open at this time.- High-Pro?le inmate resulting in Safety and Security concerns. YES El NO I: Comments: Signature ?June 2014 Reason for? current Segregation: Administration I lnmate' Request Approved by: Ms. Di Nino Name Title: Deputy Di Nino Yes I Select lenght of time Reason: Refused Opportunity to move to unit and in fear of his safety within this institution or another at this YES El NO I: Comments: Name Title: Select lenght of time Other: Other: 151 - Days junctureI Signature . Name: Reason for Current Segregation: Select Answer I Reason: YES El NO El Comments: 1mg: Approved by. Select length if time . Name Title: Other: - I .Sign_ature . - Name: Reason for current Segregation: Select Answer Reason: YES .NO Comments: - Approved by; Select length of time I Name Title: Other; Signature Name: Reason for current Segregation: Select Answer Reason: YES NOD Comments? Approved by. Select lenght of time Name 3: Title: I Other: . I Signature Name: I Reason for current Segregation: Select Answer I Reason: YES No Comments; . Approved by: - Signature Distribution List: Institution Copy Records Department, Regional Of?ce CSD 075-101 (rev. 10/08) s.21(1) 001095 . Ontars Ministry of Community Safety And . - Correctional Services I I Institution Name: 30 'Day Segregation Reprt Summary Name Title: Other: Region Month Ending/ Year Central Toronto South Dentention-Center November 2014 . Name (Last, First. Middle) Date Segregated Segregation Approval Client Identification No. (mm/dd/WWReason for current Segregation: Select Answer Reason: Mental Health issue.? YES No Comments; 10/16/2014 Admin-Mental Health 30 MHAU not open at this ?Approved by: Ms. DiNino ays time.lnmate not suitable for Name Title. Deputy Supt? Other: placement on unit. Signature Reason for current Segregation: Select Answer Reason: Mental Health issue. YES No comments; 10/21/2014 Admin-Mental Health 30 MHAU not open at this Approved by: Ms. DiNino . ays time.lnmate not suitable for Name Title: Deputy Supt, Other; piacement on "Wig Unit' Signature . - Reason for current Segregation: Select Answer Reason: Health issue. YES No Comments; 1012212014 Admin-Mental Health 30 'd MHAU not open at this - Approved by: Ms. DiNino ays time.lnmate not suitable for Name Title: Deputy Supt. Other; placement on I'V'ng un't' Signature I Reason. for current Segregation: Select Answer Reason: Health issue. YES No ?3 Comments; 10/24/2014 Admin-Mental Health 30 MHAU not open at this Approved by: Ms. DiNino ays time.lnmate not suitable for Name 8 Title: Deputy Supt" Oth?r: placement on unit. I . Signature Name: Reason for current Segregation: Select Answer Reason: YES No comments; Approved Select 0f 7 Name 8. Title: Other; Signature Name: Reason for current Segregation: Select Answer Reason: YES NO ?3 Comments: Approved by. select lenght of time Name Title: Other; Signature Name: Reason for current Segregation: Select Answer Reason: YES No comments; . Approve-d by. Select lenght of time Signature DistributionlList: 030 075-101 (rev. 10/08) Institution Copy Records Department. Regional Of?ce s.21(1) we,? - 001096 ?enta? Ministry of Community safety And . Correctional Services - a 30 Day Segregation Re rt Summary Region Institution Name: Month Ending Year - Central Toronto South Dentention Center December 2014 - Continuing Segregation Reason for continuing Continuing Segregation Name (Last. First, Middle) [gatede/egregated Segregation Approval I Institutional Approval Segregation Regional Approval Client Identification No. mm W) - . . Reason for current Segregation: Select Answer Reason: Adjustment problems YES NC El Comments; Dec 01/14 Admin-Hold on unit. Inmate fears being . Approved by: Ms. DiNino 30 day? assaulted on unit. Already I Name?& Title: Deputy Supt, Other; g'?ntlaFPI n, PE IC ml mt atle' Signature Name: Reason for current Segregation: Select Answer Reason: YES N0 Commentsr Approved by: Select Length of time - Name.& Title: . Other; Signature Name: . Reason'for current'Segregation: Select Answer Reason: YES No [3 Comments; Approved by: Select lenght of time Name 8. Title: Other; Signature.- Name: Reason for current Segregation: Select Answer Reason: YES I: No [3 Comments; Approved by: Select length if time Name Title: - - Other' . Signature . - Name: Reason for current Segregation: Select Answer Reason: YES - No cbmments; Approved by: Select length of time Name 8. Title: - I Other" Signature . Name: Reason for current Segregation: Select Answer Reason: YES NO El Comments: Approved by: Select lenght of time Name Title: Other: Signature Name: Reason for current Segregation: Select Answer Reason: YES [3 No Comments; Select lenght of time - Approved by: Name-8t Title: Other: Signature /7 Distribution 'List: Institution Copy Records Department. Regional Of?ce 050 075-101 (rev. 10/08) 521(1) ({1ng No '001097 .Ontars' Segregation (AIB) . December 2014 Submission 30 Day Segregation Re rt Summary cso 075-101 (rev. 10/08) s.21(1) Re?gion Institution Name: Month Ending 1 Year Central -Toro_nto South' Detention Centre December 2014 . I . Name (Last, First. Middle) Date Segregated Segregation Approval coqt'ng'ng segregation Reason for Conunan segregat'on - [dd] Institutional Approval Segregation - Regional Approval Client Identi?cation No. mm W) . . Reason for current Segregation: Yes Reason: Inmate safety and YES No comments; September Administrative! Inmate Request H. . security. Inmate would not sign . . ?2014 Approved by: Ms. Di Nino 93? ?9 into Part of Name Title: Deputy Di Nirio Other; 94 - Days placement rev'ew Precess- Signature - Reason for current Segregation: Yes Reason: High-Profile inmate - YES No comments; Octdber 2014 Administrative I Medical 8 I tL th f't. who appears to have Mental Approved by: Ms. Di Nino 6 ac eng Health concerns. Held for safety Name Title: Deputy Di Nino Other: 59 Days and security Issues/concerns. Signature Name: Reason for 'current Segregation: Select Answer Reason: YES CI NO ?3 Comments: [mt Approved by: Select lenght of time - Name Title: Other: Signature Name: Reason for current Segregation: Select Answer Reason: YES NC Comments: Approved by: Select length if time Name 8; Title: - . Other' Signature Name: Reason for current Segregation: Select Answer "Reason: YES No Comments; Approved by: Select length of? time - Name Title: Other; . I Signature . Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved by: Select Ienght of time Name Title: other; Signature Name: Reason for current Segregation: Select Answer Reason: YES NO I: Comments: Approved by: - Select Ienght of time - . . Name Title: Other; Signature Distribution List: . Institution Copy - Records Department, Regional Of?ce 001098 Ontaai Segregation December 1 2014 Institution Name: 30 Day Segregation Re rt Summary- to a living unit within the Region - Month Ending I Year Central - Toronto South Detention Centre December 2014 . - . . - . Continuing Segregation - Reason for continuing Continuing Segregation Name (Last, First, Middle) [gatedilegregated Segregation Approval Institutional ApprovaI Segregation RegionaI Approve? Client Identi?cation No: mm W) Reason for current Segregation: Select Answer Reason: Medical care needsI YES NO Comments: May 2014 Administration I Medical 8 I I th I I, Assaultive behaviour towards, I . . Approved by: Ms. Di Nino eect eng 0? staff and inmates. TSDC does Name 3- Titlei Deputy Di Nino Other: 214 - Days net have a medical umt Open' Signature - Reason for current Segregation: Select Answer Reason: Safety and Security YES No Comments; September Admiinistration I IL I, concerns if moved to a living unit 2014 Approved by:Ms. Di Nino Se 3? ?9th 0 '_me within the inStitution subject to: Name 8 Title: Deputy Di Nino Other: 89 - Days Street Invowement' Signature 7 Reason for current Segregation: Select Answer Reason: Own Request: Safety YES I: No Comments; September Administation' ,1 I II ht I, and Security concerns if moved 2014 Approved by: Ms. Di Nino 3 9? "me. Name: lD#: Name 8. Title: Deputy. Di Nino' Other: 89 - Days institution. Signature "July 315?. 2014 Reason for current Segregation: Medical I Misconduct Approved by: Ms. Di Nino. Name Title: Deputy Di Nino Select Answer Select lengthif time Other: 124 - Days Reason: Medical care needs I Assaultive behaviour towards - staff, TSDC does not have a medical unit open at this time. YES NO Comments: Signature 'August 2014 Reason for current Segregation: Medical . Approved by: Ms. Di Nino Name Title: Deputy Di Nino Select Answer Select length of time Other: .94 - Days Reason: Safety and Security concerns if moved to a living unit within the institution subject to current pro?le. YES [1 NO I: Comments: Signature fMay 2014 Reason?for current Segregation: Administration Approved by: Ms. Di Nino Name 8: Title: Deputy Di Nino Select Answer Select lenght of time Other: 186 - Days ReasOn: Refused opportunity to move to unit and in fear of his safety within this institution or another at this iuncture. YES NO Comments: A Signature Reason for current Segregation: Approved by: Name Title: Select Answer Select lenghtof time Other: Reason: YES El NO D'Comments: f?x Distribution List: Institution Copy Records Department. Regional Of?ce CSD 075-101 (rev. 10/08) s.21(1) . Signature $1914 001099 . Onta$ Tower (B). Segregation (AIB) December 2014 . 30 Day Segregation Re rt Summary Region Institution Name: Month Ending I Year Central Toronto South Detention Centre December 2014 I . . . . . for continuing Continuing Segregation Name (Last, First, Middle) Date Segregated Segregation Approval Segregat'on Reason . - InstitutionaIA roval Se re atlon Re Ional Approval Client Identi?cation No. (mm?dd?m?y) pp . . - October 2014 Reason for current Segregation: . Medical I Administration Approved by: Ms. Di Nino Name 8- Title: Deputy Di Nino Select Answer Select length of time Other: _64 - Days Reason: Mental Health concerns and Special Needs inmate.- TSDC does not have medical unit open at this time. YES NO I: Comments: Signature November 1 2014 - Reason for current Segregation: Medical I Administration Approved by: Ms. Di Nino Name Title: Deputy. Di Nino Select Answer Select Length of time Other: 31 Days Reason: Mental Health concerns and Special Needs inmate'- TSDC does not have medical unit open at this time. YES El NO I: Comments:' Signature November-6??. 2014 Reason for current Segregation: Medical - Approved by: Ms. Di Nino Name 8: Title: Deputy Di Nino Select Answer Select lenght of time Other: 33 - Days Reason: Inmate requires ongoing assessment through Health Care. TSDC does not have medical unit open at this - time. YES El NO El Comments: Signature July 2014 Reason for current Segregation: Medical I Misconduct . Approved by: Ms. Di Nino Name 8. Title: Deputy Di Nino Select Answer Select length if time Other: 153 - Days' Reason: Inmate requires ongoing assessment through Health Care. TSDC does not have medical unit open at this time. - YES NO Comments: Signature ,ivovember 201 4 Reason for current Segregation: Administration Approved by: Ms. Di Nino Name Title: Deputy Di Nino 7 Select Answer Select length of time Other: 32 -Days Reason: High-Risk handling precautions. Held until precautions can be downgraded based on consistency in his behaviour. YES NO Comments: . Signature November 2014 Reason for current Segregation: Medical [Administration Approved by: Ms. Di Nino - Name a. Title: Deputy Di Nino Select Answer Select lenght of time Other: 35 .- Days- Reason: Mental Health concerns and Special Needs inmate. TSDC does not have medical unit open at this time. El NO I: Comments: Signature Reason for current Segregation: Select Answer Reason: Mental Health concerns YES - No comments; November Medical I Administration 3 and Special Needs inmate. . - 1 2014 Approved by: Ms. Di Nino 0 ays TSDC does not have medical - I Name Title: Deputy Di Nino - Other; ?mt open at t'me? Signature 7 Distribution List: Institution Co Records De artment, Re ional Of?ce - py - 0:019 0V fut? CSD 075-101 (rev. 10/08) 001100 A Onta? Segregation (AIS) - . December 2014 Submission . 30 Day Segregation Re rt-Summary Name &Title: Other: Region Institution Name: Month Ending I Year Central Toronto South Detention Centre December 2014 . Name (Last, First, Middle) Date Segregated Segregation Approval ?g?m?ggliepggrecgg'o" Client Identi?cation No. (mm?de?WWl - . . . . - Reason for current Segregation: Yes Reason: Mental Health concerns Yes? No comments; ?November Medical Mental Health 30 and TSDC dees not have a I . . _'2014 Approved by: Ms. Di Nino ays medical unit open at this time. Name Title: Deputy Di Nino Other; Signature - Name: . Reason for current Segregation: S_e ect Answer Reason: YES NO 1:1 Comments: D#z Approved by: .Select Length of time Name 8: Title: other; 7 Signature - . Name: Reason for current Segregation: Select Answer Reason: YES - NO Comments: Approved SBleCt Of Name Title: Omar; Signatufe Name: Reason for current'Segregation: Select Answer Reason; YES [1 No [1 Comments; Approved Name Title: Other; . Signature Name: Reason for current Segregation: Select Answer Reason: .YES No '3 Comments; Approved by: I Select?length of time Name Title: other; - . Signature . Name: Reason?for current Segregation: Select Answer Reason: YES I: .No [3 comments; I Approved by: Select lenght of time Name Title: Other; Signature Name: Reason for current Segregation: Select Answer Reason: .YES NO 1:1 Comments: Approved by: Select lenght of time I - Signature Distribution List: Institution Copy Records Department, Regional Of?ce c'so 075-101 (rev. 10/03) 521(1) 001101 theme 9 Segregation (AIB) December 2014 Submission 30 Day Segregation Re rt Summary Region InstitUtion Name: - Month-Ending I Year . Central Toronto South Detention Centre . December 2014 . - I A . Name (Last. First, Middle) Date Segregated Segregation Approval Segregat'on . Reason for ??thum9 Cont'W'ng segregat'on - - [dd] . Institutional Approval Segregation . Regional Approval Client identi?cation No. (mm W) - - November 2014 Reason for Current Segregation: Administration Approved by: Ms. Di Nino . Name Title: Deputy Di Nino Select Answer Select length of time Other: 35 Days Reason: POLICE witness in an ongoing criminal investigation trial - Safety and Security of inmate and institution. YES El NO Comments: Signature ?June 2014 Reason for current Segregation: Administration Approved by: Ms. Di Nino Name 8: Title: Deputy Di Nino Select Answer. Select Length of time Other: 186 - Days Reason: Refused opportunity to move to unit - and in fear of his safety within this'institution Or another at this -YES Elf NO El Comments: Signature [November 27th, 2014 Reason for current Segregation: Administration 1 Medical Approved by: Ms. Di Nino Name Title: Deputy Di Nino Select Answer Select lenght of time Other: 34 - Days Reason: Safety and Security Concerns surrounding portfolio and appears to have mental health concerns - Currently, no medical unit open at TSDC. YES NO ?3 Comments: Signature May 2014 Reason for current Segregation: Administration Approved by: Ms. Di Nino Name 8; Title: Deputy Di Nino Select Answer Select length if time Other: 215 - Days Reason: Refused opportunity to moVe to unit .and in fear of his safety within this institution or another at this juncture YES NO Comments: Signature /Novem ber 29th, 2014 Reason for'current Segregation: Administration Approved by: Ms. Di Nino Name 8. Title: Deputy Di Nino Select Answer Select length of time Other: 32 7 Days . Reason: Mental Health concerns and Special Needs inmate. TSDC does not have medical unit open at this time. YES El NO I: Comments: Signature November 2014 Reason for current Segregation: Administrative I Medical ApproVed by: Ms. Di Nino Name Title: Deputy Di Nino Select Answer Select lenght of time Other; 34 - Days Reason: Inmate has requested to remain within Segregation and submitted an inmate statement in support of his position. YES NO I: Comments: Signature Name: I Reason for current Segregation: Approved by: Name Title: I Select Answer Select lenght of time Other: Reason: Comments: SignatUre Distribution List: Institution Copy Records Department, Regional Of?ce . 521(1) - CSD 075-101 (rev. 10108). . (U94 OntarQ Ministry of Community Safety And . Correctional Services Month Ending I Year 30 Day Segregation Re?t Summary 'Region' Institution Name: . Central Toronto South Dentention Center . December 2014 I Name (Last! First. Middle) Date Segregated Segregation Approval Continuing Segregation Reason for continumg Continuing Segregation . - institutional Approval Segregation. Regional Approval Client Identi?cation No. mm W) . . - Reason for current Segregation: Select Answer Reason: Adjustment problems YES No Comments; Nov 23/14 Admin-Hold 30 on unit. Inmate fears being - Approved by: Ms. DiNino ays assaulted on unit. Already - Orientation! PC inmate, pending Name 8' Tltle' Dequ SUpt? Other: nunilnhilitv of had for Signature Reason for current Segregation: Select Answer Reason: Mental Health issue. YES [1 No Comments; Nov 24/14 Admin-Mental Health 30 MHAU not open at this - Approved by: Ms. DiNino . ays time.lnmate not suitable for - . placement on living unit.Awaiting Name 8? T't'e' Depuw Supt-r Other: nf qinnln mall Slgnature Name: Reason for current Segregation: Select Answer Reason: YES No comments; Approved by: 30 days Name Title: Other; Signature' Name: Reason for current Segregation: Select Answer Reason: 7 YES 'No comments; - Approved by: 30 days I Name Title: Other; 7 Signature Name: Reason for current Segregation: Select Answer Reason: YES No comments; Approved by: Select length of time Name Title: Other; Signature Name: . Reason for current Segregation: Select Answer Reason: YES I: No Comments; . Approved by. Select lenght of time Name: Reason for current Segregation: Select Answer Reason: YES I: NO '3 Comments: Approved by. Select lenght of time Name Title: Other; Si?ature Distribution List: Institution Copy Records Department, Regional Of?ce 413? cs0 075-101 (rev. 10/03) 521(1) - Wat . I 001103 [Pentar? Ministry of Community Safety And . Correctional Services 30 Day Segregation Reprt Summary Region Institution Name: Month Ending I Year Central Toronto South Dentention Center December 2014 Name (Last, First, Middle) Date Segregated Segregation Approval Client Identi?cation No. Reason for current Segregation: Yes Reason: Mental Health. issue. YES No Comments; OCT 21/14 Admin-MentaIHealth 7 60 MHAU not open at this . - Approved by: Ms. DiNino ays time. nmate not suitable for - . I placement on living unit.Awaiting Name Tltle' Depmy SUpt" other' nuailnhilitv of qinnlp rel] S'gnature Reason for current Segregation: Yes Reason: Adjustment problems YES No Comments; NOV 19/14 Admin?Hold 30 on unit. Inmate fears being 7 Approved by: Ms. DiNino ays assaulted on unit. Already . - . - Orientation] PC inmate, pending Name Tltle' DepUty SUpt" Other: availahilitv nf bed for traanpr S'gnature - Reason for current Segregation: Yes Reason: Mental Health issue. YES No Comments; NOV 20/14 Admin-Mental Health 30 MHAU not open at this . . Approved by: Ms. DiNino ays time. nmate not suitable for Name Title: Deputy Supt. Other: placement on ?Vlng umt' Signature Reason for current Segregation: Yes Reason: Adjustment problems YES No Comments; NOV 21/14 Admin-Hold . 30 on unit. Inmate fears being Approved by: Ms. DiNino ays assaulted on unit. Already - . Orientation!? PC inmate, pending Name 8? Tme' Depmy SUpt" Other' availability of. bed for transfer. Signature Reason for current Segregation: Yes Reason: Health issue. YES No Comments; OCT 20/14 Admin?Hold Medical . 0 Medical unit is not open at this Approved by: Ms. DiNino 6 ays time. Inmate not suitable for Name Title: Deputy Supt., Other; placement on I'V'ng un't' - . Signature - Name: Reason for current Segregation: Select Answer Reason: DYES No Commente; . Approved by: Select lenght of time Name Title: I Qtnen Signature 7 Name: Reason for current Segregation: Select Answer Reason: YES No Comments; Approved select lenght 0f Name Title: Other: Signature Distribution List: Institution Copy Records Department, Regional Of?ce . . ?Oak (1M4 cso 075-101 (rev. 10/08) 521(1) . - 001104