From: "Branstetter, Paul Date: September 29. 2011 15:08:10 CDT To: Brian Edwards Subject: RE: Conract for signature Thanks, for getting the contract on the commission's agenda. Below is a summary of our notes from the CRCL close out. >199? 10. 11. 12. TCSO medical clinic is not using interpreters. CRCL found a prevailing attitude among clinic staff of indifference and. adequate care is not being provided because of lack of communication. TCSO doctors are using ?standing orders" in violation of state and federal guidelines. CRCL opinion is that TCSO Nurses are providing medication prior to doctor approval outside of nurses? authority TCSO is in ?clear violation of the 2.000 regarding dental care. TCSO is not adhering to ICE standard that after 6 mo. detainees are entitled to cleaning and restoration. Doctors having to wait to see inmates due to lack of escorts. Booking nurse?s station had food in the refrigerator with medicine. Diet is too high in sodium. Fat content 36% recommended below 30%. Nurses are undertrained. Not documenting or evaluating patients properly. Found one case clearly demonstrates lack of trahring. perforated appendix due to lack of training and Found two ICE detainees with clear mental/medical problems that have not seen a doctor. A088 513 638 has obvious mental health issues, i.e. masturbating in public, disruptive in pods. TCSO nurse documented mental issues during intake but failed to refer to provider. A077 985 977 has not received medication despite the fact detainee stated was on meds at intake. TCSO medical clinic is using a homegrown system of records that ?fails to utilize what we have learned in the past 20 years)? System is not user friendly. Facility is generally clean and well kept. Nothing found of imminent danger, but found some things need corrected. Chemicals are not maintained and controlled properly. lv?slabeledlunlabeled chemicals found. Some that could be used as weapons and were not secured. ICE requires chemical data sheets. Chemical notebooks were found where they should be but had not been maintained and updated. Chemicals were listed that facility does not use anymore. Medical unit had 3 different MSDS notebooks. Those were not uniform. None of the three were organized when it should have a master index and updated. Chemical bottles should always be labeled. Barbering is not in compliance with NDS. No barber shop. Clipper blades are cleaned with hand sanitizer because they had run out of herbicide. Hand sanitizer is not a 5 EXHIBIT _3_m . .. Glanz.02 00066 Cassand? disinfectant and is inadequate. TCSO did replace hand sanitizer with barbicide shortly after found. Box used to transport barber equip was full of hair. 13. Bedding and clothing. ICE has list of items and exchange frequency but it is nonexistent at TCSO. Many male detainees did not have socks. Staff said frequently there are no socks to issue. 14. Clothing inventory needs organization. Found clothing in large storage areas including a large amount of clothing but found no inventory. Last inventory 2123/2011. Were no socks in intake but laundry had 3300 pairs of socks. 15. There is no exchange of laundry. NDS requires clothing exchange and schedule of exchange. Found at TCSO that clothing exchange is "elective." Laundry procedures do not match handbook. Policy and handbook says exchange will be made but in practice it's not done. 16. Facility laundry is only used for washing when inmates leave facility. Some overcrowding in housing area. Portable bunks are being used. TCSO inmates using them upside down which is unsanitary. 17. Food service workers are using dangerous and unsanitary procedure for measuring food temperature. Thermometet is not sanitized properly which could lead to transmiSsion of food borne illness throughout entire facility. Temperature taking procedure could potentially spread disease throughout facility because is not done right. Need to look at ICE personal hygiene policy because it doesn't match facilities. Found excessive number of mattresses that were cracked and damaged and cannot be sanitized properly. Need replaced or repaired. 18. Food service was pretty good as far as operation is concerned newly renovated facility but skimped on equipment cost. Some i already breaking down. Tray washing machine out of order for 3 months. Chemical dispensers not working properly and needs calibrated. Good news is that primary indicators of safety (use of force) operation looks good. Very low numbers of infractions. No use of force on detainees in 6 months. Segregation is rarely used. 19. Classi?cation is being followed. Really liked that Category 3 inmates are not mixed. Using dedicated housing for ICE detainees. Classi?cation does a good job. TCSO does not strip search unless a concrete reason exists. CRCL did not say he found ICE detainees on boats but said it is inevitable that it happens. 20. Post card policy is bothersome and believes there may be a legal issue with seaming legal mail but will have a de?nitive answer in ?nal report. 21. In compliance with visitation policy. 22. CRCL has the most concern about legal services. CRCL found TCSO does not overtly block detainee access to law library, but believes there is a problem since it is so underused. CRCL has never seen such an underused library. Only 4-6 visits since January is unprecedented which means there is a problem. There is no schedule for use which impedes use. Kiosk is English only which impedes. No video orientation and Glanz.02 00067 detainees said they didn?t know about it. Need to make law library access more functional. 23. Very few forms are in Spanish except the handbook. No reference in disciplinary policy/system for language assistance during hearing. Paul A. Branstotter SDDO DHSIICEIEBO Dallas Flold Office I Tulsa, OK Tel: (91 arses-8962 Call: (918) 830-0607 Glanz.02 00068