SHERIFF DUSTIN D. HEUERMAN CHAMPAIGN COUNTY OFFICE Dustin D. Heuerman Sher?f ph (217) 384-1205 fax (217) 384-3023 Chief Deputy Shannon Barrett 1311 (217) 384-1222 fax (217) 384?1219 Captain Law Enforcement Shane Cook ph (217) 384?1207 fax (217) 384-1219 Captain/Jail Supt Corrections Katee Voges ph (217) 819-3534 fax (217) 384?1272 Jail Information pl?: (217) 384-1243 fax (217) 384?1272 Investigations ph (217) 384-1213 fax (217)384-1219 Civil Process ph (217) 384-1204 fax (217) 384?1219 Records/Warrants ph (217) 384-1233 204 E. Main Street Urbana, Illinois 61801-2702 (217) 384-1204 March 20th, 2019 Dylan Tiger 2003 Moreland Blvd, 103 Champaign, IL 61822 CU?CitizenAccess.org Dear Mr. Tiger: Thank you for writing to the Champaign County Sheriff?s Office Corrections Division with your request for information pursuant to the Illinois Freedom of information Act, 5 ILCS 140/1 et seq. On March 13th, 2019, you requested the following documents: 1. Copies of all inmate grievance documents filed in the jail relating to the subject of medical/requests/issues for the whole of 2017, or the first 100 forms filed. 2. Any relevant, related documents, including correspondence between officers, regarding inmate grievance forms filed. l?ve attached the grievance documents for the whole of 2017. Please be aware that the attached records may be redacted and those portions are exempt from disclosure under 5 ILCS because the disclosure of the information would constitute a clearly unwarranted invasion of personal privacy or may be exempt from disclosure under 5 ILCS because the disclosure would constitute invasion of private information. Please understand that in order to protect the privacy of the individuals that submitted medical grievances any information that could be used to identify them has been redacted. Information redacted includes names, housing assignments, log numbers and jacket (resident) numbers. You have a right to have the denial of your request reviewed by the Public Access Counselor (PAC) at the Office of the Illinois Attorney General. 5 ILCS you can file your Request for Review with the PAC by writing to: Page 1 of 2 Public Access Counselor Office of the Attorney General 500 South 2nd Street Springfield, 62706 Fax: 217?782-1396 E-mail: You also have the right to seek judicial review of your denial by filing a lawsuit in the State circuit court. 5 ILCS 140/11. If you choose to file a Request for Review with the PAC, you must do so within 60 calendar days of the date of this denial letter. 5 ILCS Please note that you must include a copy of your original request and this denial letter when filing a Request for Review with the PAC. Sincerely We Officer Lt. Robert Cravens 204 E. Main Street, Urbana IL 61801 rcravens@co.champaign.iI.us 217-819-3545 Page 2 of 2 CHAMPAIGN COUNTY CORRECTIONAL CENTER i INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 1/ 19/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievancer?appeal: (If the initial response is to be given by the Health Care Authority, document their response.) Your steroid inhaler is scheduled at 8am and 5pm. We have two scheduled medication passes daily. Maintenance inhalers are not kept in the pods. You were seen by Dr. Shah who did not allow a time change in your medications. There are no medical requests stating any asthma complications. If you have any further questions, please put in a medical request. Thank you, Mill/n Colleen Bros: Clinical Coordinator Date of response Thursday, January 19, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Gee-vene- Champaign County Sheriff?s Of?ce Corrections Division STAFFUSE Inmate Grievance Appeal Form 5 aw DateL REQUIRED PLEASE WRITE LEG IBLY Please print full name Cell Location if someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement Emma El Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can he found on the upper right hand corner of the original grievance response BriefSummarvofGrievance= rim ormoocra. +0 Milka mu semen 'mleolm- evau hour!? hence-e- Al?Ll?lo ?(Ex rim: Hem! 40 me, a-l- Uh AM (Li/hi flu-am 51400.!? Aiol?i?rcm hag-l Uni/m 40 4mm Jro Mm doc. le-E?M?f; ameL he, Bork no T-i- has 1-0 Show an 431;; meal. rem-\- nevi bu mo; Wed:- A-cdh?nn ii. We rafter;? inm?; I'm \rwu?tvss 3:3: meangJ Jr-lmef PLEASE use THE BACK or THIS roam IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date 7 I I7 3 (2) CHAMPAIGN COUNTY CORRECTIONAL CENTER 053/ INITIAL RESPONSE TO INMATE 3 Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 1/23/20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) have received your grievance dated 1/22/17 and logged as-. As at was stated previously on 1/19/17, we have two scheduled medication passes, 8am and 5pm. On the weekends the hours may differ as the nursing schedule is different. You were seen by Dr. Shah who did not allow a time change in your medication. Again, there have been no medical requests stating any asthma complications. If you have any further questions or concerns, please put in a medical request. Mill/I793 \luln? Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, January 23, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance lAppeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievanc Champaign County Sheriff's Of?ce Corrections Division STAFFUSEONW Inmate Grievance Appeal Form Date: REQUIRED PLEASE WRITE Jacket (on armband Please print full name Cell Location If someone helped you complete this form please provide their name: Name Nature of Grievance (only one category per grievance) . Staff Conduct Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance it - This number can be found on the upper right hand corner of the original grievance response Brief Summary of GrievancePLEASE USE THE BACK or THIS roam lF MORE SPACE Is NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date 3 CHAMPAIGN COUNTY CORRECTIONAL CENTER 0017 INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 30/ Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) 1/3 0/ 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, January 31, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. sierr? Champaign County Sheriff?s Of?ce Corrections Division 5mm? Inmate Grievance I Appeal Form PLEASE WRITE LEGIBLY REQUIRED Jacket (on armband Cell Location Please print full name If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct El Dietary Other Conditions of Con?nement Medical I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii El Disciplinary Appeal This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: Md; mph7v]? b0. 0min. when Callean cam?Io book?1m 1? Id cu dire-P .slms 41: cLu ?1&4"le um]: 56:.ch on cam my h?hhose. gum di on de?i \km' Uned? m?ro vacuit- 1m WW 4?091; dr I ma?a?d as Ls?oka :11? if can as may overt: Noel-lots'ee him cam de??P even om lam??mm . 1' do m-l was, Dr cuer uJIm. aait?rl'd: be I husbcm nl?lw Micah? PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: 19km - Wit!) A2. IO mu cg; +0 Malian ammo ?9.9,me 1H momma magma. mmMoLw?r DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 2/ 1/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I am responding to your grievance dated 1/31/17 and logged As it has been stated twice previously, medication pass is scheduled at 0800 and 1700. On the weekends, the medications are passed earlier due to nursing hours. You have seen the doctor who did not order your inhaler outside the scheduled times. You have not put in medical requests stating any side effects. If you have any further questions, please ?ll out a medical request. Thank you. 001/095 M17 Signature Date Colleen Bross LPN Printed Name Title Date of response Wednesday, February 01, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievance Champaign County Sheriff's Of?ce Corrections Division ?550"? Inmate Grievance Appeal Form Date: vol asaumsn PLEASE wane LEGIBLY Name: Jacket #(on armband) Please prian?ll name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance {only one category per grievance) El Staff Conduct Conditions of Con?nement Ell?iical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response BriefSummarvofGrievance= I have oual? ?m Marat; (Ta-?nance (damask Hn?s nfolalzim \Anl- neJr?r?mE Mu Whack We. Thin-V (MM: \m these. Jim Xqu-z ~9me Ebrru' L1 Imam when r?Jn-? 46th: J-laem new +54% Sl?le P?Frfedris \Mesainc. 4mm mu bodv Gin/l ('tfm-l bred-in ficlnl \H?u'j mr/J +19% (Trial/Ema? iUp Sen?r? J1 and have 1761? norm" 6/19 {5261: Halts ?le k0 c0m\np. ver\\u \niva th?l?um mac) dry/Ital; i-C'Tdsei My Wiffl< fla\\ 4?0 will PLEASE use THE BACK or THIS FORM IF MORE SPACE Is NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER 590??! INITIAL RESPONSE TO INMATE Response to grievance number: - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 2/ 1 6f201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) am responding tO your grievance dated 2/16/17 ?led as- A second mattress and second blanket is denied per Dr. Fatoki. A release for records has been signed to Obtain your medical history. If you have any further questions, please put in a medical request. WW 7 ?7 2fl6il7 Signature Date Colleen Bross LPN Printed Name Title Date of response Thursday, February 16, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance {Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff?s Of?ce Corrections Division A inmate Grievance Appeal Form ,5 ASE WRITE LEGIBLY 20:! Name Jacket (on armband Cell Location If someone helped you complete this form please provide their name: Date: rlcuac In" quI Natu re of Grievance (only one category per grievance) Staff Conduct ?E?Cbnditions of Con?nement .E'IVI'Edical El Dietary Other El Disciplinary Appeal I I I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievancewhen [luv/y {xi-n7 ?ied, new; PLEASE use THE BACK or THIS FORM u: ~1an SPACE Is NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by My; Date CHAMPAIGN COUNTY CORRECTIONAL CENTER (2 INITIAL RESPONSE TO INMATE 2/ Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 2/22/17, logged as- There have been no medical requests regarding any muscle pain. Please fill out a medical request with any medical concerns that you have. Thank you. 3cm Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, March 03, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Office Corrections Division inmate Grievance Appeal Form Date: 2.721 7 REQUIRED PLEASE WRITE LEGIBLY 6 (q Please print full name Cell Location if someone helped you complete this form please provide their name: Nature Of Grievance {only one category per grievance) Staff Conduct Conditions of Con?nement 8 Medical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand comer of the original grievance response BriefsummarvofGrievance= LIONS: mv amt-{val 37m on '2017. I was lmtw?m?ri-na? nmmviwni?lr'v in,- r. atlmirf- Hmu/I/ 351? Y?rmalz. ll/m?rg? 45mm: (mm! [WrJi/?Al A?c??limk. nsA?n-J Elf-ll: mm in Palm. NV :?rilv as ?frown ?My men and! limiters: as 4d Av? 'l?AMIu/z. Wiwwiiw d?r-?mhual, I (uanjtvickA; ditch,? moclL ?orid. also a (idiom (?nnq?f?ny-Hco mark/d? Di; mesrlr bacK. Mic/1% (?hL?fm Hinrf'img. 72/;w: hr Palm Bis-l (?cs'w 610' 'l?LLs is Ri'olicul?os/ +Lrvr Plerms con-L TAM mt 9 Air/Ll ?Am-l +61 re: Tn Inner inn ?ask) in 775M mr. (L4 crl- mt (furl-1A] mu Fahd hide, I?Lacf HFnu-aD 'Molkm/ Emu. 1?le filtrate! MA TM Hir. l? (?mu n/?Hso is 77?!ch I/uauld rhuclx Ra lLsf5??. Th! [Via/(ff Mar-5s reads res 3n 7L: Distant; Th Hr?a ?oss; TLa-l- urea) Hz/vn' "l km y'oo kw me; awe Corimianm Heb. PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received Date ?00 5'50 35 {pm?J 5 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance 2? Appeal From was received by the Corrections Supervisor or Program Coordinator: Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) WW5 Signature Date Colleen Bross LPN Printed Name Title Champaign County Sheriff's Office Corrections Division Inmate Grievance/Appeal Form '5 Date: I PLEASE WRITELEGIBLY Please print full name Cell Location if someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct El Conditions of Confinement Wedical Dietary H'Other 9w as r: L, I mALIJuss QMWI- Disciplinary Appeal Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response BriefSummarvofGrievance= TocIr-Mr 12. ?Md- sq, he been AMI rLuI'hAt Md vie-.1, \(uD tub: ten: an? moi? nIr W. 15.1.;0 AMINM Mmo u?c-f LugI an?. 0 hitch?: (fa-m: charmUCLm-?j? InmmI' tire. Ila?Lem. Wonms A?vfi MI tua? him +6 Wtiitu) MW DIIQ MILD: ?10?!th atria-Lt 50m! RILW PW 4440 alkali-r [drip am! If? Irlln?L?lf-LLH Ad! Ivan/H L. Imam ma: . {Locum Asia.? Dari-'1 ?4.44! M. 19:41 ruhgnelumas 1 545? ML: hat-Jan UH L: Era-Lanna?- mu? 1:55:10"- ruILh Lind} Im: Em. 'Lf jn Mir act-ooh!" MM MAI-L?Iiquuammti? nit?PI. I'm lie/tun ?nulyl?m but JeIfrm n/rn?dl 44411619. 1: agn4.#' Nd ?1:.ch Ila/l. ?f-?-mult a. Ema/l full. Wat!? ELGL Jury} pdavu thr'I-S on. Kinny/?4L Udiieeka?r yard-w MI ?4 added; nun 0 11 (HA-S r; hlf- Iw? in! tic/1m hark. in LL41 ?at! Sibel M1. LI mm Nakfhl?mh?z'li" (unfi' mi?. Ln Liven?La mm] 525 not) u-Lai' -I-o wad?? arm. 4.1 mom-i .t?te?iimm edta 494?! cu,? in?ur ALLA/whit Aw! ?rs-49 12m wad" (magi-? IQ Liam/K. I?m) {fan-Ir IAALJC din/Ll In If.? Nib (rs/i (thy. wot.) Le.? ML iguawi: u'O PM. WLM (imra? Wow merre has A ?x-LuotkLm MA \mD-erIivc-A: Wu? (11%de PLEASE use THE BACK or THIS FORM IF MORE SPACE Is NEEDED ReliefRequestedr ?Thom TS Noe? 11mm II?cn till-(4cm Io rma'mkrw on. rurILtht-m And In Wt; 0mm Ceding MIL rur? of: GOIIpquncs Lin). ImmILu 4.4.1.1 KniokmeLo .to?Irh As; 3151qu \T?s m3 nth?I- I?m 9911??: ?ant/294 WUIQJ Tim WM (#91th 0'9, mm?iOan. TIIA-II No3!- cm Canoe/M. Lax rLrlerisi-u .. wens, Art??I ?Item?s ken swam. DO NOT WRITE THIS LINE - CORRECTIONAL STAFF USE ONLY Received by I fg?i? Date I 7 /3y/ CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: a Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 3/10/17 and logged as - I have only received 2 medical requests. One dated 3/7/17, the other 3/10/17. You have seen an outside doctor twice. You also have an upcoming appointment with your outside doctor. Their of?ce aware of your Per oqunedication record, you have received your ointment four times a day.If you have any further concerns, please ?ll out a medical request. Thank you. MOSS 3/13/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, March 13, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate rievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan Champaign County Sheriff's Of?ce Corrections Division WWI inmate Grievance/Appeal Form --. (l . REQUIRED ITE LEGIBLY Jacket #ion armba ease print full name if soIr'neone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Stal'r?arnjuu conditions of Con?nement WMedical [3 Dietary . Other Disciplinary Appeal I I Date of Report Date of Hearing El Grievance Response Appeal. Grievance ll - This number can be found on the upper right hand corner of the original grievance response Brief Summary 0? Grievance' Eh 96.30l'1 0J1- QC) I oo?l? 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S?cu'ci I Ami fair-7:19am mu we: It: ul- Ge-i? ?merel- Hc. ?01.11; S?ul?cr and tank. Md pm?cribc Mr. oil'rhenl and ?at PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date a 1c 65 3 mg oi. if 02.. PO. 399? 9 $03 9* 0. ..w0 3.3 .908 ways? f0 ?0 .u ?aw? we. 3 02.1 9.7ch Atom cone or. 957a. . roam 4.50 ?nv 04.. .9: ?avon. Jain?. or mz?rvuht .H. 0! Wu 4: n?hkl .W 4.6 o: 22.9 1. $03 or? fawn. an Eco; .5 my?? Coin o; 9a? 30 San. rank/4M .5 am? 05046.. . wee: 93m @46ch 095?ch a? ocw we. no. 35) 95qu fa. 35 EU $36 was?. 1390 95m .91. m?cxo 05 3% can. Q5 hcxmo 39 91.9fm: I Aw? 0.5 00,5 (Hal 0090.1 H. Jun/4,79 3% Eur. acag?w EDP in. we?? .00 pix/Rx E. 00%. E, 23,9 13?; Exam ?3.03 3 Far more.) H. 32+ 9 E59. 3w ?New ?Enid. 95a.? 36%. 5.5.7 .3 .3 a. w? .9,q $.302. mi; m9. 9 3m, 398; o. 65? 43 9.35. .35 3a on? 2w 0021 mun. kn. mam ?92. 95$: 3U ?zgergfo 3% Qamnamxyno: wed 40%? swag?? 30 CW5 g3.? 07 922W Mac? U?gg? 0? g. 00/1 1.3.0.. or 00.4 .. are? .391 m? 93 mi. 0. H5 4. 05b.? 0. a . 2,820: ,0 .903 Guava 3m PUP 96am 97m. wash?u in. So. mxfom tug max Naocb Pumas we haw. 9 012.3%. 9550 m. . 5%09 12d ?nd/9r ?0 woasw QFWJ 95% Fir. Tea?. Mu Cu. 93 3d a. my; 9.93 9? 9.. Cu. 5% ma?a? w?z? .w .107 9. H059 9.05?. CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE RcSponse to grievance number: - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 3/21/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their reSponse.) I have reviewed your grievance dated 3/19/17 and logged as-, You saw the doctor one time for your breast lump dated 3/1/17. You saw the doctor dated 3/15/17 but it was for back problems. You have not put in medical requests stating you have a continued breast lump. Please ?ll out a medical request stating your concerns about the continued breast lump so you can see the doctor for that issue. Thank you. OWQS 3/21/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, March 21, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan- Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form Date: REQUIRED PLEASE WRITE LEGIBLY Name:_? Re?nement Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) IE Staff Conduct Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing El Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: (- MI \m i A E-s- 4 If. I Gm (lkt. '3 .li PLEASE use THE BACK or'n-us FORM IF MORE l5 NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received Wm SKA Date 8? PI- C.) 2 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance x? Appeal From was received by the Corrections Supervisor or Program Coordinator: 3/28/20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 3/26/17 and logged as- The Wal-Mart pharmacy on Prospect has been called to verify your medications. You have not been compliant with any of your medications. Your Plavix and Lisinopril were last ?lled 12/2016. Only a 30?- day supply was given. Viagra was last ?lled 2/2017. These are the only medications on your pharmacy pro?le. Due to being non-compliant, the doctor has not continued these medications while incarnated. Your blood pressure was also within normal range, there is no need for blood pressure medications to be restarted. Thank you. W99 3mm Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, March 28, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievance?L Champaign County Sheriff's Of?ce Corrections Division STAFFUSE a Inmate Grievance Appeal Form 6 (D Date: 39 I 'l asumaen PLEASE WRITE LEGIBLY Na me: Plea print full name If someone helped you complete this form please provide their name: #(on armba Cell Location Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Confinement medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response BriEf Summary Of Grievance: lame been ham. ?5 . d. I 7 Lil) 7 I hows. nut-4:5 41.9. do"; 1? natal Mu: hmrJ? meal t-f-h- bled-(f rs: aw Gluerm-A emblem: Clo r0" h: mu Mani ihl mar, Risa Rana: er-th I kw? 1? milCcI??I in My! all? 5 an-f; k1!n.rh If JC hr. 44?13 . ham-IS ll UaIMcf-il? on Mar-bx Pressure?rA- En arm?. I rag Slim: 4c." Co 1! ts ..Ln ?cm Shots-fun! :Hzel- bet/ewe ch-l .. . . . x) PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: I aft me Mr {VI-Lr'l'lnnl Tx all .T. aski?ar .t .2 . - DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ON LY 353-? Receivedb Date 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER RESPONSE TO INMATE ?7 Response to grievance number: 2? Date and time Inmate Grievance a? Appeal From was received by the Corrections Supervisor or Program Coordinator: 3r'28r'201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievancefappeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 3/25/17 and logged as- I have a medical request dated 3/26/17 for cold /allergy There are no medications to give for these aliments per the nursing pathways. Please turn in a medical request for a headache and a one-time dose of Tylenol may be given. If the headaches continue, please turn in a medical request to see the doctor. Thank you. W93 3x28! 1 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, March 28, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this rcSponse. Champaign County Sheriff's Of?ce Corrections Division A ?55 Inmate Grievance Appeal Form 5 (7 Date: REQUIRED PLEASE WRITE LEGIBLY Name:? Jacketmonarmbanu Please print full name Cell Location If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Medical I: Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance1M2Jilin r? 0 - ~IPLEASE USE THE BACK or THIS roam IF MORE SPACE IS NEEDED Requested: 70 0 im/ (?D-Hum? a UPSP Im DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received 3140? 7325' Date 31/25:! I1 CHAMPAIGN COUNTY CORRECTIONAL CENTER 3:3 INITIAL RESPONSE TO INMATE 29/ Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 3:28:20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 3728/]? and logged as- You put in a medical request stating your throat hurt on 3.327? 7. It was responded to by nursing staff on 3327!] 7. If you are having diarrhea put in a medical request. Thank you. ng 1?28! 1 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, March 28, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. are! Champaign County Sheriff's Of?ce Corrections Division 5mm? Inmate Grievance Appeal Form PLEASE WRITE LEGIBLY Date: ?3 REQUIRED Jacket (on armband Please print full name Cell Locati If someone helped you complete this form please provide their name: I i?L {if L?kb Nature of Grievance {only one category per grievance) Staff Conduct Conditions of Con?nement E?Medical Dietary El Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Re5ponse Appeal Grievance it - This number can be found on the upper right hand corner of the original grievance response BriefSummaWofGrieva?ce= h?d PM 90,612 (Uni; .4 we; we, a 1.04?; 4:?ip/I. mi I max) PLEASE use THE BACK or THIS row is MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELO LINE- CORRECTIONAL STAFF USE ONLY Received Date?gg95?1 6 05/5 9/27,? CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 3.53 0/20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievancee?appeal: (If the initial reSponse is to be given by the Health Care Authority, document their reSponse.) I have reviewed your grievance dated 3/30/17. You are prescribed by Omni Prosthetics ?Certain Dri anti-perspirant?. This is what was approved by Dr. Fatoki. That is exactly what was ordered and received from the pharmacy. if you choose not use it, that is your choice. If you have any further questions, please ?ll out a medical request. W98 3/3031 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Thursday, March 30, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff?s Department Com 0F 5 Inmate Grievance/Appeal Form a? ef?gy) 9L3 Type of Grievance: (circle one) Medical Conditions of Con?nement Disciplinary Appeal Inmate Nam? Last Name First Name Middle Initial Inmate Cell Location: - Inmate Jacket For Disciplinary Appeals ONLY, provide the following information: Date and Time Disciplinary Report was given to you: Name of Person who instigate the charges: Rules Violated: Date of Disciplinary Hearing: Names of Disciplinary Committee members who participated in the hearing: Sanctions Imposed: Provide a detailed explanation of your Grievance/Appeal (if more room is needed attach additional pieces of paper): On} {?0th +0ch Si?f/ LJl?lA?l- cm: vuetwiav/ ?(O?cl?loedt? Wanamenlu? Glance? At-lmb xterm LJIOS +oolC saihetn?: thOS new (Mn: mun/a .Dmmr tl-emc 453::- MMGOPICUL gr lQmehul? Jim} 4010' I Lav/cl lam 9003!: (jurJ ?in il-Ntr {mull 0-?an tier?; Card-C .tt Dr": Sle Lei-ma) Dom gins (0057a all! ?mtgl?r?v ?nallatu?n 3i"; Lt Elm-emu I was gamut. ??nll anti/nation} D?t I awful if? M?bd Siuf/ Jinx. Dml- LiulL op lam/nu. LAM lefrJu-QQ lint. Wall can) \a Set mall sisal Lajatl" t'l? chl' ma Siam.) SDrl?ut?eaer uni-h it: much 0N rem S??m l'olek chili $33 Lari/Ira] line. Qtell Jim; I IN: Ajol- unfit/?mt SLR: ltml'LeJk 03 to) 4-0 ll" mak 3(4th LJAl?ru-dz late: Cattle-mm) Canal? 56.601!!th S?l?i?cl?i diam I was talul Bu Ll-ual- NA l-u {up all Hm; Rolled Gul- anal 1mm) 1" ND ?re?y Judo Watts hulk (3th Car-ink) 3ft lei- OP/Qotraxm'i' 1};ng Con?alien.) 'l-ntml l'D o?cub ML, (1&ng Car-lentil bat mall mo alt) mul- [de?le wrath (Mt?i \thQ. \X?ta Ara mm NJ: Db tl? work: harm (l?sciJL 510mm ts mollmrucq Meta) -l-lmg Dh?f ?f?o?l?xel-L, mealmh?r?mtl? T?tlEn?sLl?cel net. in Car-ill (meal 'l?ell Mun/x linol? ?at, an? we'l- (Len-t Sure. th/lli Vow to gel? rvu? Hm {ht/C. If someone helped yout out this form provide the name of that person: If you are at the downtown jail submit this form to the Administrative Lieutenant. If you are at the Satellite Jail, submit this form to the Program Coordinator. You will receive a written response within 5 working?ays. omnl? PROSTHETICS 8: ORTHOTICS _Will need access to the following items for proper prosthetic management: Alcohol spray to don the liner Certain Dri anti-perspirant to be used as directed on his residuum Skin Lotion from Alps (100% silicon oil) Monistat Soothing Chafe Relief gel to be used for skin care If there are any questions regarding- or the above mentioned items please feel ?ee to call and discuss any concerns! 217-344-6664 Thankyou, 1 1 W. Robert Devlin, CPO CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 49632017 Lieutenant/Sergeant or Program Coordinator?s response to grievancefappeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 4/5/17 logged as_ You were never placed on the doctor?s list. You put in a medical request for a second mat. [t was denied by Dr. Fatoki, our medical director. Dr. Fatoki was given your concerns, medical background and request over the phone. A second mat is not medically necessary. If you have any ?thher questions, please ?ll out a medical request. SS 4f6f17 Signature Date Colleen Bross LPN Printed Name Title Date of response Thursday, April 06, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievance- Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form 3 (i Date: ?acumen PLEASE wane LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Natu Df Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement mMedical Dietary El Other Disciplinary Appeal Date of Report Date of Hearing El Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response BriefSumrnaryofGrievance: I 4-inch} 1m to. no.) 9" +0 GUOIINIL Ma?i? vIrm an) QDPCOURE Mum? \et. TH (155.com DC Kor?mcx} 3: Wm; msI? Kat/K Jmu. Log Ta 5 ?tnjebf?I'iML her?ha, (Hunk War-x3 Imam/x (?lA?ll? BE orioF?er ?grit Orf? .30 er- {brie-e.) usage/x ML [Lt-q (1an what) .5: made. Jo mm Irm DR 45:341.) mm GINA Mk. NT pram - 'I'ftuk urea/(cf ??50 DUIJ- at Midr?tuI Pewed? irU 'Lo ?ee. o~r~u\ CCBIIEL rig-II 0/0 4?131- OboInIb On) 4/5/9017 and lnIaI I?ium 1: I-IIJILIGQ hi; 0x ?nu? . ?hb OIF rjch'LA? Emu] lime. how CAM ?che do #144? PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: .40 (CC. afar/fa: 40 6 {it DO NOT WRITE BEI. THIS LINE - CORRECTIONAL STAFF USE ONLY Receivedby?_? I @r Date I?ll/g/l7G/Z/?Sf WV CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 4x'20f20l 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 4/ I 9/ I 7, logged as You ?lled out a medical request on 4/5/17 and 4/14/17 about your sty. Both requests were responded to on the same day the request was made. On the second request dated 4/14/17, the doctor was noti?ed and ordered warm compress. You were also told not to squeeze on your sty but did so anyway. On 4/19/17 you were told again to stop squeezing on the sty and to use warm compress three times daily. An email also went out to the corrections staff to notify them to allow a towel to be warmed three times daily. This morning on 4/20/17, the sty had decreased in size. If you have further questions, please ?ll out a medical request. 4/20/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Thursday, April 20, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievanc! Champaign County Sheriff's Of?ce Corrections Division STAFFUSE Inmate Grievance Appeal Form Date: #494017 asouuneo lo PLEASE WRITE LEGIBLY Name?_lackemmr H. Please print full name Cell Location If someone helped you complete this form please provide their name. Nature of Grievance (only one category per grievance) El Staff Conduct Conditions of Confinement El Medical Dietary Other I: Disciplinary Appeal Date of Report Grievance Response Appeal. Grievance it - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: Date of Hearing 5.1m; Earli/ 3: Pillar] (Mite;i Tkriz Mfrb:m( Rt?mvsf' Rearmi??nn rinLi?Pw?. N/Jicczi' ?i'cn< u'i' Chat- I Lnrinlfam1m? Luflaii'jl)? 3? bid . Lint-4- TL .q r1: la-sf- nmo? Ilia-1 I . a-l adiorr'm Imn?n?r:rm 1mm. Ins-mid. ?51: an!" R: 1mm: Milne; c372)! 53 TLz'r lrus leifn.) Elmd?'m l? tan ?/71 2617. ?aky/l ?rur14mhbfohcs Dragging. adv: {ca/w: Kine) as: R/li'xpr, I, A margin: hum {In-mm; I Fu/ 11.4 Muskrat {3 Ordnancum .1 .J a; .a 77?s mrmvi'ct/ Eff; MI. rhr? Vrr? Cur mm? .1 I Dare H- TrcA/f Cili?na r: TA n/I- .J PLEASE use THE BACK or n-us roam lF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date Nana Griffin From: Jeffrey Eads Sent: Wednesday, April 19, 2017 6:01 PM To: Corrections Subject: Due to the severity of_sty on his right eye, and the need for additional moist heat to be applied, have left a bag at the B-Pod desk. If at least 3x daily someone can heat the moistened wash cloth in the microwave (no more than 15-20 seconds), it should provide him with enough moist heat to help reduce the swelling and irritation. ?aw/ CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE ReSponse to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 5/3/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) - I reviewed your grievance dated 5/1/17 ?led number - If you have medical concerns, such as pain while using the bathroom, please ?ll out a medical request to see the doctor. Thank you. W89 5/3/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Wednesday, May 03, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this reSponse. rievanc Champaign County Sheriff's Of?ce Corrections Division 57?? Inmate Grievance Appeal Form 5-1-17 Date: REQUIRED PLEASE WRITE LEGIBLY Name; Jackemm?- Please print full name Cell Location If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance it - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: 51/0? 6am ail/awed ?+li in ?kause 75:46; 5? .exam have, personage! a u?pa in awash?), I am ?4114'?- +142. hut-HA roam . slim .Pmm'x-m? Ba and? Mar/[n :1 +Lm< ?l?Lat Morin-l? ?0 await! alt-x} a whi??z, bin-e! fat-kn! Pia-f? and +Leixg 51m ?ahsmx ?in [ta-L er (aria/M: +Lui'1'T .ISamaer?v-w?fc (70+ rte-Iain ?x?m Mi? .r?ine 444%,? reparto/ 1019.?! WM {Ar me? l-le. said +L.p pres-44.4w. aka M5 Do mm 50952116 am 3/411..de 5-, can?) ?ml when? new/? In; many?, WAD luv. it, ?Mcng/ {ht-a ,om ?mag/r, 54.; ?465? 51! -my?c. d/Ji/vm . 0r. Jaw? f/zm r; MAJ-ham Areas/r 59$: 3* a pr/src: mm . amal?i?s ?n-H'Zemb-In can?! 53/. 51w .wny?b; 0MP, dam mH:a:-7 [gl?r n7 ?14 :62} an mm.-ano/ meo/rmwa ix. rlM/lwz/?: M11. Sim.? Hosp Tin-e, sar'c?? Mn fray-min vl- 5/aMr r?m?x a Ida 2% I: r-l- ail-31? nae/222:6} m: wile m9 rel-Loner [9]th {1?va arr/?M ?Radial. lag) alien?s}; pd?n-km?v a ?fmn o/?/awfalo- 59 meter; ?n Mao-r- ?1 f1? I's'M/lrz/r /ps ambit?#11 pmsv?m'tg, WV N020- QWH a?IW?j-ff {rev $441414 (Mn/?rm if fs' an 4:2! ?sh-4? luv yd?Zg in Ag. Flam! SJM M?gna?rel/rfn .E W, Mid Ana/{u ?fth-f? l?dcm If: HP f/a/n?rx ##4qu ppm; .1: ?mkn ?id-ea,- A?hnx Aa/cb . g?u avid-1, bW'Aal/enir ?egmq?/fm (ML flea-[5? PLEASE USETHE BACKOFTHIS Forl?i IF MORE SPACE IS NEEDED Relief Requested: 45 atria-7'1 4' Mbn?a,f a511,] ?n +14; p/nmh 550% Mle (U ?rm can +l~o~y 5?0 3w nJoRLgiv MuiL/Crxy 014.2. I F5 49 upgrnehw 57/143. 4 Mme-.4 mm 0/ can rag fringe/J. LIL-ides rre?ar/?M v?L-w-f' 3+4- fame/i ?ute/yaw! 71.3. mi, Aasai?Tz. la Smam 4'0; a/fSrcaApr go!? Cd'i? an gel/ax oI-H-zr? W?fL?Cl/jxl (Ila-j- 14.41;? ?cm 51:4521/2 "f'oucln +0 '1 and 5143711412 mb?m flu-2+ fir-42. Q'fa a 0 57%? ?az affL?Im-T fA?-i- mule! cam-1e. gloat/#1 flu, zit/nude DO NOT WRI LINE - CORRECTIONAL STAFF USE ONLY ?rm I [n BELOW Received '5 (17W CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 5/ 8/201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) reviewed your grievance dated 4/2! 17, logged as - I just received your grievance and your medical request asking for your records this morning 5/ 8/17. You were on Bactrim DS twice daily for 10 days. Thank you. CW 58 5/8/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, May 08, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this reSponse. Grievan Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form 6 Date: REQUIRED PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance [only nne,category per grievance) . - 1 El Staff Conduct -. Conditions of Con?nement m'?edical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance ll - This number can he found on the upper right hand corner of the original grievance response Br ef Summary of GrievanceKnow M. PLEASE use THE BACK or THIS roam IF MORE SPACE l5 NEEDED Relief Requested: rl DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER 5 INITIAL RESPONSE TO INMATE "9 Response to grievance number: 1. Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 5a?29f201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance logged as- dated 5/24/17. If you would like you AIC checked, you need to ?ll out a medical request to see the doctor. If you have any further concems, please ?ll out a medical request. Thank you. W98 5:29:17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, May 29, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form ?3 I AFF USE ONLY Date: REQUIRED PLEASE WRITE LEGIBLY Name. mm ease print fuli name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) 1 Staff Conduct Conditions of Confinement Medical Dietary Other Disciplinary Appeal Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the originai grievance response BriefSummarvofGrievance: whom 1 \?chd MU Vl?AHCchul 1+0? ?ham 1: Mar; Await?r, mu 551 an?; Md can ?5?0..de Ain?aht I $03" ?if" A-jf (?1?ng DJ) fish has. Amiga-he: Apr! (.0 Cir/ow ?fan-A90, l-n cash grunt-Ll w'i?ila fine? lcln? 4an vote mica-1? I elm-48?? til-l- limo. kart-3n Cid'ano lit/Haul- lope-115 (in/(T r354 4?0! Tight lag/61; 1 C640 not t3:- midi/30! inc/Sf?em? PLEASE USE THE BACK OF THIS FORM IF MORE SPACE 15 NEEDED Requestec?: 1 Gt: (K :?Bril?i +0 {Jig-3 somg? - a king? 3/001 Ir I .r .I . lie- IE. .I 1le Hf} uh? big??13 {5.11:1 SEQH ?afsmk/J '5 fin-T we 1? In?ll": ~lo Gels? r/ A3 at a; Eager: \5 DO NOT WRITE BEL THIS LINE - CORRECTIONAL STAFF USE ONLY Received by?\?t (.330\ Date CHAMPAIGN COUNTY CORRECTIONAL CENTER 3 INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance/ Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/12/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) reviewed your grievance dated 65:? 17, logged as number- Your multiple medical requests have been responded to in a timely manner. Treatment was given based on your and the provider?s orders. You have been placed on the list to see the doctor this week 14/ 1 7). If you have any further concerns, please ?ll out a medical request. mm Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, June 12, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievanc- Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form Date: 5 (99? REQUIRED PLEASE WRITE LEGIBLY ?mg?Met mm Please print full name Cell Locatio If someone helped you complete this form please provide thelr name: 4/ Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement . Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing El Grievance Response Appeal. Grievance It - This number can be found on the upper right hand corner of the original grievance response Brief 5 mmary of Grievance: c/ xx'zz74') ?g 775117,514hogl "4.$3.44 9. en 36' n) .Ne'i" PLEASE USE THE BACK or THIS roam IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by :5 L56 9? I Date 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance r? Appeal From was received by the Corrections Supervisor or Program Coordinator: ?20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievancelappeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 6/10/17 and logged as - In the grievance you indicate that a nurse approved for you to have ice for 24 hours. I did ?nd an e-mail from Nurse Eads on this subject and it does state that you are allowed ice for 24 hours. as stated in the e-mail, you are ?allowed? to have the ice. It was not prescribed. What you may not have been told, and for future reference, you need to request the ice from staff and if necessary you need to request more when the ice melts. Grievance closed. Lt. Robert Cravens 352 Lieutenant of Support Services Date of response Wednesday, June 21, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the tap of this response. Champaign County Sheriff's Of?ce Corrections Division ?55 Inmate Grievance Appeal Form c. 7 Date: (pg/0 20 REQUIRED PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement edical El Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance it - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievancezl-qui/ f5 70' 71 MM -&17 df/ avg/ha . r? ~14 f' 1744 116/ 7 4261/ I?l- 33A ?t my,? leQr I 49 PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED (35d Requestedgig: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by 2 ?g 3/901 Date Robert "Allen" Cravens From: Jeffrey Eads Sent: Friday, June 09, 2017 11706 AM To: Subject: _is allowed ice for the next 24 hours. JEFF EADS LPN CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE 2/ Response to grievance number: - Date and time Inmate Grievance I Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/20/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance number - Medical staff has requested your records ?'om CarIe on 6r'13r? 17. We are waiting on the paperwork. Without prior knowledge and documentation of past medical records! treatment, the doctor cannot start treatment. You are receiving pain medication for your knee pain. Once your records are received, the doctor will review and decide appropriate treatment. If you have any further problems, please ?ll out a medical request. MW 58 6/20/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, June 20, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division 57"? 0" Inmate Grievance Appeal Form 6 ?1 Date: 2 REQUIRED PLEASE WRITE LEGIBLY Jacket #(on Please print full name Cell Locatio If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement UMedical Dietary Other Disciplinary Appeal Date of Report Date of Hearing El Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance respo 5e Brief Summary of Grievance: r" I Tifrom SJ . . J: I I '25: a . kirk nitlziw?. 5 L: ?La? ?mad hi 95X??to a ABE Aug/A120. .5216 /4 I m! .. T/M/lm .507? 1:35.1. ?1496 :55! A .. 7 r! PLEASE USE THE BACK or THIS roam IF MORE SPACE as NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date A5 dm7nased MM 75:99 v-v? ?me 0" bill/5?0" ?n 0mm? 6% '75 525w" . . fig/5335 ?fW? CHAMPAIGN COUNTY CORRECTIONAL CENTER ,2 INITIAL RESPONSE TO INMATE a? Response to grievance number: - Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/20/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance numbered - You have seen the medical doctor. You have received pain medication and ice on multiple occasions. Medical staff has requested your records ?'om multiple locations for doctor?s review. All medical staff has responded your requests in a timely manner. If you have further concerns, please ?ll out a medical request. 6/2_0/2017 Signature? . Date Colleen Bross n] Printed Name Title Date of response Tuesday, June 20, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division inmate Grievance Appeal Form 5 (l I Date: 7 REQUIRED PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement edical Dietary Other Disciplinary Appeal Date of Report Date of Hearing [3 Grievance Response Appeal. Grievance if - This number can he found on the upper right hand corner of the original grievance response Brief Summary of Grievance: 7 Mfr/tic/a do . 5 I 5 YVH- [Lg/41 chat - PLEASE use me BACK or THIS FORM u: MORE SPACE IS NEEDED Relief Requested: ti (7 I. a: DO NOT WRITE BELOW THIS - CORRECTIONAL STAFF USE ONLY Received by LU 36/5 Date (b//7/l7 do "7.5 mm M5. 4470/ CHAMPAIGN COUNTY CORRECTI NAL CENTER INITIAL RESPONSE TO INMATE r2> Response to grievance number: - Date and time Inmate Grievance I Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/23/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) reviewed your grievance Medical cannot replace your shaving cream. I personally have never even seen this cream. Your family may have shaving cream brought in for you. If you have any further questions, please ?ll out a medical request. Meg 6_/23/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, June 23, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grrerarr- Champaign County Sheriff's Of?ce Corrections Division STAFFUSWW Inmate Grievance Appeal Forrn Date: Z0 2 acumen PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) I: Staff Conduct Conditions of Con?nement wedical El Dietary El Other Disciplinary Appeal I Date of Report Date of Hearing El Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: \n (A I Shademl: of? (Red (PLEASE use THE BACK or THIS FORM IF MORE SPACE Is NEEDED Relief Requested: . a/oa/c/ 2?0 Mew/1' Mam f0 m? m/f,rrc jhar/? 7L4g+6wi? K/vr-A IQ Co 120/? 0/2: rind/Mr r. car/jg ova; 1/7 Cir! remove; In hc??lfh ?an! on? I . DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance I Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/28/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance logged as- You were given Tylenol for your knee pain. You then saw the doctor on 6/28/17 regarding your knee pain. You were prescribed Naproxen for your knee pain. You also moved to a lower level, lower bunk to help. If you have any further questions, please ?ll out a medical request. W93 6/28/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Wednesday, June 28, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievance Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form REQUIRED PLEASE WRITE LEGIBLY Jacket #(on Please print full name CEII Locatio If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement XII/ledical Dietary El Otherc El Disciplinary Appeal I I Date of Report Date of Hearing El Grievance Response Appeal. Grievance This number can be found on the upper right hand corner of the or ginal grievance Brief Summary of Grievance: {3 \?Lrg in a \lmln??r5522slam in - . me . 420 Jen "Ix limoeslhn Cr) 57cm and r? hf 12%? mi A ?7/7 THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested?N?rx DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received Date I 9 If) Grieva Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance I Appeal Form 6 (D oatezel a} 7 neoumeo PLEASE WRITE LEGIBLY Name? Jacketmonarmb Please print full name Cell Locatio If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct CI Conditions of Con?nement .Medical Dietary El Other Disciplinary Appeal Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can he found on the upper right hand corner of the orlginal grievance response BriefSumrnaryofGrievance: '3 rams: (obrn??v't \agA 4t \0 tech Alxem-c 9n mom Mn Schwinn- \3n\ th??axee?rc on MK. ?0 mm: \?x?n?tq rah-Ir- ?.lmm mx 8GB \n??lx?c \Dn\ \Qum \H?k PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED ReliefRequested=1 A We) \ncc gem-x In?. MN: viewer \Ihmk? In? m5: (?r?kivxq ?at" \Wx5? DC \r-yno. DC i?m 3R th-i WQGA 9? \las. V3510 Am. 5n meow)? ?it mew-I \I?ot?k?m Qi? C'ix e. kt: nu R?rlb umnA mo While new A DO NOT WRITE BELOW THIS LINE CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 6/30/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 6/29/17, logged as-You have seen the medical doctor, you were given pain medication twice daily. You were given lower level, lower bunk but continued to use the stairs regardless. There is a shower located downstairs as well. The medical doctor was informed of your fall, prescribed an additional one time dose of pain medication which you refused. You have walked, stood and sat without showing any signs of dif?cultly or pain. This is all on camera and witnessed by several of?cers. As explained previously, the medical doctor comes once a week on Wednesday and you may?Iii?mI?then. If you have any further questions, please ?ll out a medical request. W93 6/3 0/1 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, June 30, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievanc Champaign County Sheriff's Of?ce Corrections Division "55 inmate Grievance Appeal Form Datezgg i?l aeumnen PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement mMedical Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance ReSponse Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response BriefSummarvofGrievance= in #29? i?i \anm?L?iD?. was Alma \D?Aow Afimtmr? it emgi Alan mi Knees min \nncr Lena-Y t5. \??itie q?iw; sinn- neuev? in: 1m; mtAkmAr?e RAM. Am An 35:033. rA mm Aka}. MAW me clad? and at). \nmch be?? ch ?Av; \?rAe-Awr Ammo? A LAC Qty-?n mend pre?x magi-Rmt: Alia 1: Mheniwc. ii (TL.MQC m: quS 9.x \mori r1" \A?ctA F. 1r: 1: ?e?n?l 1.111.. AA \nc: Amt-v9 Ale-?rink Am 9mm Arimxx mobs. A MA A Anmxr? hm; TA. Albert, TAD \nm . \m 41A Abuja; Aneiar Nam-i Alum-3e- 1m: (?huh-i SidxAu?Ak. \nc? LNWAAQ DALLU \n?i?ic \nu-S?t? cm" in. moi Care-14?? Won? 11? \mori $916k? mm): me- PLEASE USE THE BACK OF THIS FORM IF MORE SPACE I5 NEEDED REHEfReqi-?eStF-?d: 2m a \ni Cnmto?t Qua: mm?) LAMA, MDLBA \Aqr Qmev?- enmmenAA ?Kim A 10ml! .9. Amn?t $33nd ihwm. 1' ?am Arm \nc: Acre game-name 3m SEE (>ch (SQ-EL omxmd ?m \k?Ynk? 6'11:th amt). {no.5 hini?J?Eure..weno issue-z. r? Luau.? amoeba-ha (hug- Nv?u? Mn ham m? mm m?atnm. Loam! l5- leMm ?53025? 'f?i?bi?dwy Ines. .. tar-m \lsI-nu (5606. E5 Sing.? GD intent. ?4133 Madam: Catt may be. twitch h'nu) F?mt?l check ifyr??tirtimt?. mu Imam?: Elna- ?rm. animhi 93? \3 Cmgma 1m}. II: have. ?led at emu/mm my ON (3113?. OHVSS Mia Mme-Iv rvru (?J?bhhs'I ?gural: var-Ha colleen Indiana ?Ital mm dc, 4:5??de 551mm: welsh mu?thFaJ (censusi problems is less Hum ma?a S?mhal he. $113335 Itk?L site. has tus-i- Hm. om When we. Item 'I?Ptmia It: Momma WV Mam-m INLP as m. DvoF-tSSro??tI we] S?Wla .sl?mid {Mair- wm'v'qiu and Hal?- Ahmad-cu exit to F1 gelr- an cut-Ir ?at-Ewe.? film MIME: femur . 0 PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: . . . . . Ate ewe/3; awmwawm {Jr-met Monica; (mm. hum Mug ?tawny Manila: wart in Al DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by 3 3?6 (IL Date 7PM '7 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE ReSponse to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 7/31/2017 Lieutenant/Sergeant or Program Coordinator?s reSponse to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance logged as- You put in a sick call 7/26/17 about your swollen gums. You were then placed on the doctor? list for the next Wednesday, August You have been placed on antibiotics and pain medication once already on 7/ 15/17 and then another round of pain medication on 7/301'r 17. Your ?rst grievance was responded to on 7/20/17. If you have further questions, please ?ll out a medical request. gs 7/31/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, July 31, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this reSponse. Champaign County Sheriff's Of?ce Corrections Division lnmate Grievance Appeal Form 6 (0 I Date: REQUIRED PLEASE WRITE LEGIBLY im? Please prlrIt full name Cell Location If someone helped you complete this form please provide their namg/ Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance reSponse Brief Summary of Grievance11/1 Vin In r- I . 46.: PLEASE use THE BACK or THIS FORM IF more SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by a! ii?l Date CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 8/2/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 7/30/17, logged as_You saw the medical doctor on 6/28/17 for your wrist pain. He did an assessment and treated you accordingly. He prescribed pain medication. If you ?Irther medical attention, please ?ll out a medical request. owes 312/1 7 Signature Date Colleen Bross LPN Printed Name Title Date of response Wednesday, August 02, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan Champaign County Sheriff's Of?ce Corrections Division 5mm? Inmate Grievance Appeal Form 5/ Date: REQUIRED PLEASE WRITE LEGIBLY Mm_ mm!? Please print full name Cell Location If someone helped you complete this form please provide their name: Natu re of Grievance (only one category per grievance) El Staff Conduct Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I I I I Date of Report Date of Hearing El Grievance Re5ponse Appeal. Grievance ll - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: I A r: (an. fir 463W ?l 7" 0 PLEASE use THE BACK or THIS roam IF MORE SPACE IS NEEDED Relief Requested: _nv' Received by Date u? CHAMPAIGN COUNTY CORRECTIONAL CE ER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance/ Appeal From was received by the Corrections Supervisor or Program Coordinator: 8/8/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial reSponse is to be given by the Health Care Authority, document their response.) I have reviewed your grievance logged as_ dated 8/5/17. The medical director has been called about your emergency follow-up visit. He prescribed the Ranitidine for your heartburn. If you are having headaches then please ?ll out a medical request regarding headaches. You have placed on the doctor list for Wednesday 8x?9f1 7. He comes once weekly. W69 8/8/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, August 08, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance 1 Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grieva nc Champaign County Sheriff's Office Corrections Division STAFFUSWNW Inmate Grievance Appeal Form (2 Date: g? 5 r) 2 REQUIRED PLEASE WRITE LEGIBLY Jacket #(on armband Please pri tfull name Cell Location Name: If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Wdical '3 Dietary Other Disciplinary Appeal I Date of Report Date of Hearing El Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: I, up (9qu orig; r?l?'f :J-v-rPLEASE USE THE BACK or THIS roam IF moms SPACE l5 NEEDED Relief Requested: 'Jus Mn mu :0 amnr 0/ 141/1 Ya I) - 1.- DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by?w/ Date 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER 75 I 0L INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 8/8/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial reSponse is to be given by the Health Care Authority, document their response.) I have reviewed your grievance logged as- dated 8/6/17. You saw the medical doctor on 7.326! 17 for knee pain. You have been on pain medication/ anti-in?ammatory. You have also put in several applications to become a trustee, indicating your knee pain was relieved. There have no further medical requests from you regarding your knee. If you have further concerns regarding your knee, please put in a medical request. We 3/3/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, August 08, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this re3ponse. Please reference the grievance number listed on the top of this reSponse. Grievanc Champaign County Sheriff's Office Corrections Division Inmate Grievance Appeal Form 31 1&0 '3 .. .. 9.424 7? Date: neuumeo PLEASE WRITE LEGIBLY 5(7 Name: JaCket #(on armband] Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement ?Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: "Hm Cluirjil?T-was H0 ?Hua Mariam/3&7 \yewl aver/151213 when -i1d+ a. sharp parry do my Err/1? j: ?+onecl and rm: 2h) Amprnau Mqucl-t (has: mall?s-Ah; Saar/WA stud/M10 "Hi9 (MA) was r; M) :JmlolL 6mm 'hte 4MP Muse {minutes Hire/?W irrodpn'r/aml ms meirm?m/ +0 45H ind-a Mom?M bio/A) :3 Law/(5 and eff/7 am liar/MG +r0uA/z walking [rm work gt 1 3an +142 (/0er (HANS an Iharzam?iv . I 4ch I Meal medial +rm3?m emf- PLEASE use THE BACK or runs FORM IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date 6 CHAMPAIGN COUNTY CORRECTIONAL CENTER 507% INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance 3' Appeal From was received by the Corrections Supervisor or Program Coordinator: 81? 1 1:90? Lieutenant/Sergeant or Program Coordinator?s response to grievancefappeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 8/7/17, logged as_ You have seen the medical doctor on 8/9/17. He prescribed medication for he deemed appropriate for your medical conditions. If you have additional questions, please ?ll out a medical request. W99 3/11/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, August 11, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division g; Inmate Grievance Appeal Form Date: REQUIRED PLEASE WRITE LEGIBLY Jacket #(on armbandi Please print full name Cell Location Name: Nature of Grievance (only one category per grievance) Wonduct E?ditions of Con?nement El Medical El Dietary El Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response If someone helped you complete this form please provide their name: Brief Summary of Grievance: u' PLEASE USE THE BACK or THIS FORM IF MORE SPACE IS NEEDED Relief Requested: ith/J bm' 1 1 DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by ff?i Date I 5 CHAMPAIGN COUNTY CORRECTIONAL CENTEK INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 9/26/201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 9/19/17, logged While in the jail setting your mental health physician is Dr. Hussain. She has prescribed your medications, which you refused to take on multiple occasions. Re?isals were signed. Your medication orders were discontinued due to non-compliance. If you would like a certain dosage of medication, please relay this when you see Dr Hussein again the ?rst of October. W98 9/26/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Tuesday, September 26, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grieva Champaign County Sheriff's Of?ce Corrections Division 5mm? Inmate Grievance Appeal Form 5 (0 Date: REQUIRED PLEASE WRITE LEGIBLY Name: Jacketmonm Please print full name CEII Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) El Staff Conduct Conditions of Con?nement I-Medical El Dietary Other El Disciplinary Appeal Date of Report Date of Hearing El Grievance Response Appeal. Grievance ii - This number can he found on the upper right hand corner of the original grievance response 1 Brief Summary of Grievance: PLEASE use THE BACK or THIS FORM IF MORE SPACE IS NEEDED Relief Requested: rr Ilia. n1 .9 DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date 1'1 4?4?\s?5 S's-e 3M paw Jm?j Dawss 451;, Try 44 ms +5 ?2533?, saws: ML L0 ?Passes; his s?s hiss if 33;) yrs/s53 sass-sky Jeff?s 413.0 72mg 904 5+ s. CH j: Sg??p W4 sisass 4 has Lusaus mess 31.444 slaw; is "4 3334'? assays-s H-- 0 asi?uws ans} ism ass h?wg a 3spsiasd "Ms-4s spun; Dam <54} (43' ?353 Help? psome Estofem my ma?w. @342?) $411: 3 ?gs 4? C. CHAMPAIGN COUNTY CORRECTIONAL CENTER . INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: IOIZIZOI 7 LieutenantISergeant or Pragrmn Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) reviewed your grievance dated 9/29/19 logged as_ The medical physician did not order a diabetic snack as you only take oral diabetic medication. You are also now re?lsing to take your diabetic medication. If you have further concerns, please ?ll out a medical request Owl/W93 mm Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, October 02, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form 7 Date: PLEASE WRITE LEGIBLY Name: awn armband Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Dietary g/Otherdg ?m?j Cit r; El?. SOQC-K. [3 Disciplinary Appeal 9Q ?1 Date of Report Date of Hearing Grievance Response Appeal. Grievance it - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: :13le {5196 in. [new a} tram ,3.ch have .?Hh . . . 2&3 . imh- Chilling-FCC h;ql?\ big/id pat-953mg. New malai- '1 creek? (2 Snack \Nncs JD) Make, r?l- e?c-iamucisin [?1le ?n dating and (Omega, antic; moi) V000 4a CS'Jrln-er' an ?ergmi? #i?h A?(?j?rj \rMm W'il_{ gcta-L-C?E??h ME USE THE BACK OF THIS FORM IF MORE SPACE I5 NEEDED ReliefRequested: \Dould ire;- SnMa Ana. . (\rx . 4m vaiome o?r?ir-qaef QEKAQ \nmJe (T Ssrvaneis: and da (?adieu-Leon DO NOT WRIT THIS LINE - CORRECTIONAL STAFF USE ONLY Dateq Mac? (-1 Received by .1- CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 10/6/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I reviewed your grievance dated 10/4/ 17, logged as- You put in a medical request about your hand on 10/4/17. You were placed on the doctor?s list for 10/11/17. The doctor comes once weekly on Wednesdays. If you have further questions, please put in a medical request. W95 10/6/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, October 06, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. 1.. Grie- Champaign County Sheriff's Of?ce Corrections Division STAFHEE NW Inmate Grievance Appeal Form Date: REQUIRED PLEASE WRITE LEGIBLY 6 Name Jackewionw Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance {only one category per grievance) Staff Conduct Conditions of Con?nement mMedical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response BriefSummaryof Grievance: funk. hcl?l? 3&3 {3 . . .61; . II Fame a Lima in "a le'ir-I ?iA-l' c. dnucLWM, on jig/e307 PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received bi? 3/0? Date Cl/, f7 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance I Appeal From was received by the Corrections Supervisor or Program Coordinator: 1 0/1 6:201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed you grievance dated 10/9/17, logged as - We have faxed Carle GI for your records to corroborate you needing a special diet. We have also contacted Piatt and Macon County Jail for your diet/ medical records. Once we receive these records the doctor can order a special diet. If you have any ?thher questions, please ?ll out a medical request. ng 10/16/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, October 16, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. From: Jeffrey Eads Sent: Wednesday, October 11, 2017 6:32 PM To: Sheriff - Corrections; Sheriff Correction - Medical; Sheriff Corrections - Master Control Subject: Brenda did the medical intake on this afternoon. He stated he has Celiac disease and has to have a gluten free diet, is lactose intolerant, has chronic back and neck pain, and is anemic. He came in with Gabapentin 300mg- 2 tablets twice daily. Dr. Fatoki would not approve that medication and it has been placed in his property. We contacted Dewitt County and they said he was held in Piatt County and the Gabapentin was all they showed for him. He was in Macon County prior to that. I called Macon County. They faxed me his med records over from 10/1/17. Although there is no medical diagnosis or record of it, they had him on a gluten-free diet. They did see on camera that he traded food for milk, put the milk over cereal, ate it all and drank the milk, so they discontinued his lactose intolerant diet. There is a longer list of medications from Macon County, dated as recent as October 1, 2017, and we are waiting approval from Dr. Fatoki. We have ordered his Gl records from Ca rle, where he states his Celiac Disease was diagnosed in 2014. Once we obtain that information, we can alter his diet, if necessary. He can remain in booking this evening and we will have his medications confirmed, and hopefully his diet as well. There was question as to why he was housed alone. Medical did not require special housing. We show nothing medically that would prohibit him from being housed with others. JEFFEADS LPN Grievanc Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form 6 (R Date: neuumen PLEASE wane LEGIBLY 3 Please print full name Cell Location?? If someone helped you complete this form please provide their name: U3: Natu re of Grievance (only one category per grievance) Staff Conduct Conditions of Confinement EMedical pELQietan-y Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: 771 CUTIM 4.PLEASE use THE BACK or THIS roam IF mane SPACE Is Relief Requested: adv/ire lo/D mime 5 ?io srrabwj . I DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 10/ 16/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (if the initial reSponse is to be given by the Health Care Authority, document their response.) I have reviewed you grievance dated 10/1 1/ 17, logged as_ You have been on the doctor's list for this Wednesday 10/18/17. If you have any further questions, please ?ll out a medical request. 10/16/17 Signature Date Colleen Bross LPN Printed Name Title Date of reSponse Monday, October 16, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division 550?? Inmate Grievance Appeal Form Date: 24? I g: nsoumco PLEASE WRITE LEGIBLY Nama? lactation Please print full name Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) El StaffConduct Conditions ofConfinement ?Medical Dietary Other DisciplinaryAppeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievanceii - This number can be found on the upper right hand corner of the original grievance response BriefSummaw of Grievance: Tim-?3, Dari} \Nprk? ?i Tan-\? at in ?Hit-7' Pr r. i9 ?Etc: . ?uimiin if om? I a?I? no 1.. 1?If\ 41TH: ?N?J?tz??EhhTR-Pll rhigt?l?r ,.tmm 5? lathe ?tau .3 wm '.b.>lvx K. A. (A '1 MACE mim . 4/6. MAO Ah! 5(1) he ?r ?53.111551 i ?c 11% INK Mac; ct Jim iirx? maxi Iv'ilxht} ?ix EEO "i Tahv?m? .Avxr?t . .Crtv?t?b Arr Im/ Wi?u glib? Sat?\mr. two (Affair. 5i i\ Emma i?D .IAMIM in Tim Micro?lm My; ui/QV. $Atv?t. an Air :31, (?me MST: MINA 7?1" 1511ng we. Ftkiem kai? Y5 PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received WM Date ID j/v/ 7 4/0 a- ?5 CHAMPAIGN COUNTY CORRECTIONAL INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 1 0/1 9/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 10/17/18 logged as_You have not put in a medical request since 9/25/17 regarding any pain. You have seen the medical doctor twice on 9/20 and 9/27/17 regarding this leg/ hip pain. He has ordered x-rays that have come back normal. If you have any additional questions or concerns, please ?ll out a medical request. 10/19/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Thursday, October 19, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Griev Champaign County Sheriff's Office Corrections Division Inmate Grievance Appeal Form 5 Date: 00: I'l' 20/7 PLEASE WRITE LEGIBLY Name: Jacket #(on armband Cell Location Pl ase print full name If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement Medical Dietary Other El Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: I Hide." BEEN A GREAT DEAL ON (My ?6737- OF 309V "45/ r: if? 17 1'5 no?; .5723?- .J: dram? 5am remade ?m MEGS. To Her/?7 7746;? 1'7? M45 SEEM Aiytros'i' 2 man-Ha; Wait-5. ICAM No1" K6637 T'Ai?utq 77,5 x24nv MEN, - 174mg Tat-3M Nerve. 51%? err-:7] NOTE-roar). a: New To 556' A reform! Dean: arm moat ?than 1?5 mus.? This amen Film). I HAVE SEVEEAL TIMES To 30 TD Ew?lqe'ucy d?'dllusc, and This uni-1535M 24w. WAKES m: up AT Nigel Som??mfs my we cums c197 and ma? HEM WAIK. - PLEAS H500. 5mm was-'5' My {Ecan??sanc?mrq'. 1's NOT A (5,900 Fig/Hg AT Au ?ght) I Wmi? H305 ?ail/? PLEASE use THE BACK or THIS FORM IF MORE SPACE Is NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY ReceivedbyF/?z ZZFJU Date /7 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 10/20/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 10/ 18/ 1 7, logged as _You received your x-ray on 10/18/19 and were given your results on the morning of 10/19/17. It takes approx. 24 hours to get x?ray results. W3 10/20/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Friday, October 20, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance I Appeal Form Date: /0 PLEASE WRITE LEGIBLY Nam . . Jacket #(on armband Please print full name Cell Location If someone helped you complete this form please provide their name: REQUIRED Nature Of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement Medical El Dietary Other Disciplinary Appeal 1 I Date of Report Date of Hearing El Grievance Response Appeal. Grievance ii - number can be found on the upper right hand corner of the original grievance response _Brief50mmaW?fG?evance= rm mug/m 1' Mom at Viol/I a Roux. i423 been 90 Aau?i Rifl?ff mu? \mmA ems M?Wlu ohmkb'kdo Ore-Illa: mark 3 2.34:on erg-Jar +142 4?ch- 341\l Lil?mrmh 0-9 the CPSUHQ. (AS 05} Alan. 4-er rr?u?SQS boa hole been no?I?vllm? 111m demamn?im counlrucA mob of lack. 0L aAe/Jua-lc, m-e?tco\ News.? is mu nnIu lr??il?I?r d?l?lemol 44:: mv orLSofvr mu Vin inqrifg?mnna] Oldcc?ufe? I PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Rellef Requested 40 (omit: r?nun?xvl tun R?xne. have bet-en woke) nan-i- +o (?gr-use. all-h ?1 Gatin- gg?t JAA (maime. (max (?9129/ emulating +0 GoonQel DO NOT WRITE 33.3 THIS LINE - CORRECTIONAL STAFF USE ONLY 3:503 Received by Date I0 7 (O ?3 CHAMPAIGN COUNTY CORRECTIONAL CENTER 75K INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Urievance Coordinator: 10/23/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 10/20/ 17, logged as A response was already given regarding the complaints of hip/leg pain. If you have additional concerns, again please ?ll out a medical request as previously directed. 10/23/17 Signature Date Colleen Bross LPN Printed Name Title Date of response Monday, October 23, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. 4- Champaign County Sheriff's Of?ce Corrections Division 3mm? Inmate Grievance Appeal Form Date: Qd'l'r 29- 20/? ?gunmen PLEASE WRITE LEGIBLY ~ame:_ Hammad; Pleas print full name Cell Location - If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Confinement El Medical El Dietary Other Disciplinary Appeal Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response BriefSummarvofGrievance= I KJEP Agra; cue me'oum sine-mm Fa? mi, 144170 177/4? I: AM zJAw'rrq My :4er e' 1561?." 7: ??va?cv Mom?: ?/6qu This Tb; Arsa gEEu Trt?mq val-nu M??oxui?m cart?!- T'h; 4,45'3/ ZVA Months Tr: 2:00ch wus - mv Au!) Egg/18:97:15, 1?s Mm- 86M: Props-2'1, ATTz-rumt?" Tau '77/5? NUESMG HAW: A d?ESnoM?ie?liv To 551/: 1'1? we: MT caulk-?? THAT 1's No?i? Ravioli AT Astana. EMA.- To BESEEM By SOME- ONE I DD Merl- WANT To ((3539 T?ghi? M505. ?1 I I I i PLEASE USE THE BACK or THIS FORM IF ~1an SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date ?5 CHAMPAIGN COUNTY CORRECTIONAL CENTER WW INITIAL RESPONSE TO INMATE Re5ponse to grievance number: Date and time Inmate Grievance 1' Appeal From was received by the Corrections Supervisor or Program Coordinator: 11/9/2017 Lieutenant/Sergeant or Program Coordinator?s reSponse to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed your grievance dated 11/4/17, logged as On 10/4/17, Dr. Okezie saw you in the in?rmary. You stated your last asthma attack was in 2015. Dr. Okezie did not prescribe the requested Xeopenex, but did place you on an asthma action plan. If you have any additional questions or concerns, please ?ll out a medical request. 1 1/13/17 1 ature Date Jeffrey L. Eads LPN Printed Name Title Date of response Monday, November 13, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the tap of this response. ?1 AW Grievant Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form U5E UNLY, Date: 01 neuumen PLEASE WRITE LEGIBLY Please print full name Cell Location If someone helped you complete this form please provide their name- Nature Of GrIevarIce (only one category per grievance) Staff Conduct Conditions of Confinement edical Dietary Other Disciplinary Appeal Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: Mme. Herein I Martha alleqes Dead-or Dkazi-Q has -l-n ?xkilm Gross del?Itoero?-t janIcIcerIamrIe Gar we gngomS new-1?s 'Is a. and (Lame o-C under on u. (2. MSG. \IIoch-l'incI Mme 8'51!? \Amew-lmmI-l-s Carmel UIm/Isucd I J'Idp\ SLVIDLLS. meri'ICLOLl 0.3 ?ollow5. II woul- on or oIbowl- If)! a We ar?II-chn-l- SoquI-l- Medium QHm-?r?. on Dr. Dk?it?? {comes-l-?IAOI ?eooevx?CXII Branch: Medina-How artewIn-l? has boa/I Dre'S?LrI'ha?L Car 32' digs Mom I.I reSb?IrIlIov?Il and Doc-liars pal/I1: LI oIleAJ'Ialt-Ip Mme. UNI-amt. Sum-ems. mu Q. DocAor OligLI? LLA Some: has}; oI. \K'Cbrm?ead Lime qr:tV0u?:??- We. DAMN-F JI-I-I primer-doe. Mm. SmiA Deserts-A 56ers VI 1M 0? clef IberoIA-e. IWdI-C-Cerew .9. Low. IS 0. MIN-cud ova?r-?L DCJ unwecgesw?u . In I Dr lam-L cum-l has. ?Mme ?arrival Ham dime. V1. .1 Int-1.. I \M'll- Miami-"Ion PLEASE USETHE aacxormls FORM IFMDRE SPACE Is nssoeo Relief Requested' J4 Okemw Guru-l oIMovI) gal-33$ gf?myg MA: in bi )2.erle n~LoA [01.1 OI. LoMD-Q-lron-k hon-5m? OI-X- PAH IMW I. 2 X-eot?h-evvex {3m $1ther - ?1 P) I ?uoarrl MowJI-unl Qm- DoIva in Mme amoum-L o-C RIPQDO SumeH-Ia Fl DO NOT WRITE BELOW THIS LINE- CORRECTIONAL STAFF USE ONLY Receivedby ?yjj?i Date 9/ 7 6? CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE is? Response to grievance number: Date and time Inmate Grievance .1 Appeal From was received by the Corrections Supervisor or Program Coordinator: 1 1.3291201? Lieutenant/Sergeant or Program Coordinator?s reSponse to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 11/9/17 and logged as_ A copy of this grievance is included with this response. In the document you claim that you submitted a medical request, but have yet to see a nurse. I sent medical staff an email asking them to see you during their next rounds. Grievance closed. I Lt Robert Cravens 352 Lieutenant of Support Services Date of response Friday, December 01, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievance Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form 5, Date: aeoumeo PLEASE WRITE LEGIBLY C7) Please print full name Cell Location If someone helped you complete this form please provide their name: Nature of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement ErMedical Dietary El Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can he found on the upper right hand corner of the original grievance response Brief Summary of Grievance: ems: use THE BACK or nus FORM u= mone SPACE IS NEEDED Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date It/lb f/i? 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER (3 INITIAL RESPONSE TO INMATE (y Response to grievance number: Date and time Inmate Grievance .3 Appeal From was received by the Corrections Supervisor or Program Coordinator: I ?29:20] 7 Lieutenant/Sergeant or Program Coordinator?s response to grievancefappeal: (1f the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 11/12/2017 and logged as- A copy of the grievance is included with this response. Ms. Myrick I have spoken with Nurse Eads on 11/29/17 and he said that you have been informed that you can purchase soap ?'om commissary and how to inform correctional staff of your need if you do not have funds to purchase soap. You were also told to submit a request to see the doctor if necessary. Grievance closed. Lt. Robert Cravens 352 Lieutenant of Support Services Date of response Wednesday, November 29, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division Inmate Grievance Appeal Form if Date: l3? l2. "1 amumen PLEASE LEGIBLY Please print full na Cell Location If someone helped you complete this form please provlde their name: Nature of Grievance (only one category per grievance) Staff Conduct El Conditions of Con?nement Medical El Dietary Other El Disciplinary Appeal 1 1 I .7 I Date of Report] Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: we; teak) Jrgp_ Lr?Dtl?. imu Frag-:9 ml? harem) 0.36.1th Lt? Y?ldh? Cir I :12! (U lab-F lg (ll \lLManLh?r?C; . Qt. LL. ?gl? 3: bwi?yl- 41w H1 1 the: r51 44 marlin: 4?5144! lG-v?mlul?? mix-l? 143Vim[mm-nah. no; .Gde! ?l?lnmJ-FJ hWaV' 504- gm 4 414(7) anon? Imluo nn W10 if]. lhtgia' .350 I i thEHI4:341:54 ill-C) nl? U?r?a Relief Requested: PLEASE USE THE BACK OFTHIS FORM IF MORE SPACE IS NEEDED DO NOT WRITE BELOW - CORRECTIONAL STAFF USE ONLY '7flUU Date ll ?15/ Received by L) CHAMPAIGN COUNTY CORRECTIONAL CENTER ?34 INITIAL RESPONSE TO INMATE 3 Response to grievance number: a Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 1 1/29/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievancelappeal: (If the initial response is to be given by the Health Care Authority, document their response.) have reviewed the conditions of con?nement/medical grievance submitted by? It was dated 1 1/13/17 and logged as The content of this document would require?to see our medical staff. 'was released from the Champaign County Correctional Center on 1 1/14/2017. gag/4M Lt. Robert Cravens 352 Lieutenant of Support Services Date of response Wednesday, November 29, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Champaign County Sheriff's Of?ce Corrections Division STAFF Inmate (:?Irievancelilil?iil?al Form G39 lid/{10h If) Date: I 2/ REQUIRED PLEASE WRITE LEGIBLY Na me: Jacket (on armband Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct I. Conditions of Con?nement 8 Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brie marv of rievance: a ?lm Time1675 -- . mam MW 6 we ms WW $442139?)an ?16 ROMM dimmed/u was wed-i cm/(l (Him 10mm! mama 6371910th I meal/1 mg ENDS. mad M41119 #3de 1:59, and This? IVES .T?n Am. ?bl/WW (?5?th (obi-I'm 116:1 Hie/f amp W16 42(4me mm In. Wu? Moravia, ma igymi? Fl- dih mommy Mm d?nriiawm me mm, aacooM/Vha win the II. In We met. Win/em 68640.4(; (imam 4 mmlommv? m2. in? ME +1719. Chaim" nfa'i?u?i?lylia?ize? him 1126' Tag, ?mg?rfv ,gL ?11975? I PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED a Medial a: nu. WI, ?Lem mm: milder on. i" Otv?Rii at. il?rnl? Ti)? Wi? le Iona/I .sn ll! Hal?? ?ner] mi twinge ml rh?eg?prl in THQP i?D?rr: fail.? 5 61%?ng alga. elief que DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date CHAMPAIGN COUNTY CORRECTIONAL CENTER (:33 INITIAL RESPONSE TO INMATE i Response to grievance number: Date and time Inmate Grievance/ Appeal From was received by the Corrections Supervisor or Program Coordinator: 11/16/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 11/16/17 logged as_. You were charged $3.00 for a full tube of hydrocortisone cream in response to your medical request for treatment of a rash on 11/11/17. You were also charged an additional $3.00 for ibuprofen, twice daily for seven days, for a medical request concerning dental pain on 11/14/17. Charges are displayed on the front of the medication cart, and are outlined in your inmate handbook. 12/01/17 Date Jeff Eads LPN Printed Name Title Date of reSponse Friday, December 01, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grieva- Champaign County Sheriff's Of?ce Corrections Division ?muswm Inmate Grievance Appeal Form REQUIRED PLEASE WRITE LEGIBLY Jacket (on armban Please print full name Cell Location If someone helped you complete this form please provide their name: DREW Name: Nature of Grievance (only one category per grievance} Staff Conduct Conditions of Con?nement Medical Dietary Other DisciplinaryAppeal ?l?l 7 Date of Report/ Date of Hearing Grievance Response Appeal. Grievance II - This number can be found on the upper right hand corner of the original grievance response BriefSummarvofGrievance?gal-L have gnu {vi-mime $1!an ilir?rnml ifrl It! HI: .3164 301)); j: Im?k miriJrr-u if: . ?.41 In rm I n?icii?g/ 4101!? L-f if; ?f'l (Egan/F #4an 3?31 ruff? 4r- him-P JJS aim/TH; ?i ?ghn? ?rigid .I?fim {5258' inhaling FILL-QT, ?3!me Urinal/a gruff .1 Jr 3? I?m-Ir Inn nil Mgr/um? ?or (muggy L-l' PLEASE USE THE BACK OF THIS FORM IF MORE SPACE I5 NEEDED - Relief Requested: DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by QWW Date lil [Ill/l. CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE 3 Response to grievance number: Ci Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 1 1/ 17/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 11/16/17 logged as_You initially saw the doctor on 10/11/17 for a lump in your right armpit. The doctor prescribed to apply to the area. You chose to stop using the medication due to further irritation to your armpit, caused by the medication. You again saw the doctor on 10/25/17, and based on your complaint of the medication irritating surrounding tissue, you were placed on an antibiotic and pain medication for 10 days, with instructions to be seen in two weeks. The doctor, for an unrelated requestand then saw you for the armpit again on 11/21/17. On that visit, the doctor assessed the armpit as being abscessed, placed you on another antibiotic and pain reliever for 10 days. You were instructed to change the dressing twice daily, and apply warm packs three times daily, and you were compliant with those instructions. Based on a recent conversation with you, and visually examining the area, your condition has now improved and the area is healing. Based on these facts, the need for outside medical treatment was not necessary. Should you have any further questions or concerns, please ?ll out a medical request. 412101/1 7 Date - Jeff Eads LPN Printed Name Title Date of response Friday, December 01, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grieva Champaign County Sheriff's Of?ce Corrections Division ?55 Inmate Grievance Appeal Form :5 ?7 Date: ?i 7 I ?7 asuumen PLEASE WRITE LEGIBLY Please print full name Cell Locatio . If someone helped you complete this form please provide their name: Natu re of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement Medical Dietary El Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance ii - This number can be found on the upper right hand corner of the original grievance response Brief Summary of Grievance: A I ,1 ?1711?? bro . +h~FmJ r?s? Ail/izL PLEASE use THE BACK or THIS row IF MORE SPACE Is NEEDED Relief Requestedina? DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by 30250] Date I (107/ 71?3/ 7 CHAMPAIGN COUNTY CORRECTIONAL CENTER 6 INITIAL RESPONSE TO INMATE 70:) Response to grievance number: a Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 12;?201 7 Lieutenant/Sergeant or Program Coordinator?s response to grievancefappeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 11/25/17 and logged as_ A copy of the document is included with this reSponse. The content of this document does not constitute a grievance, but the content of the document is of importance and I can assure you that your friend has received medical attention. The concern for your friend is greatly appreciated. Thank you Lt. Robert Cravens 352 Lieutenant of Support Services Date of response Friday, December 01, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan Champaign County Sheriff's Of?ce Corrections Division STAFFUSEONLV Inmate Grievance Appeal Form Date: Mg (in IN 25.2017nsuumeo PLEASE WRITE LEGIBLY i 7 Name? Jackemmba Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance [only one category per grievance) Staff Conduct Conditions of Con?nement I?Medical El Dietary Other Disciplinary Appeal I I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be found on the upper right hand corner of the original grievance response BriefSummaryofGrievance: I was lure an Origin-r 3.20!) leau?cj 200p.? lit ?-1104!th (ovaH fail in UKbnm sulluns ?u loco/(ms ll. l?er alltr?lcd tron-l1: (Lt-m Pr?f?l? was inlet run? haulage? molar 'l'lnb nurse. {:I?ull?l Cowling We? l\oil lecmnl lum U0 anl 59w. cm AL ?New il'lfla?l' b?fdra l??rl Icfl- Prlj'on he, l'lqal Sol malo (m MM other IdMailff and A: 901! Sfu?llcl Will?x Oi Pine. {Halal incl. i1L braKf all min In? undcr arm l?l?P'l' Culhm. l?l'nm (an lhr-i Pl?tr. (Hi-l l?hm oul +0 lacal Gillcin'ia'or. (acre "Me Luv-luvs (Hilly lHJnAmll I hem 'llNL Qil?lli'f kulldl?? I?lown lawn Tail latMonti me. back. l0 'lhis fail ?me. new Malian an; Me an cu-P. chl?ulcs ma. l'uJ' Muller :3 wet-3? StrioLJJ um) Sada! em}; on (H Et-l?ol ~lo mullet-c. he?j Squlinq ?ng 4mm. l?xe C?in'l' SlerP ?ml Pitt: o-F {halal Peal/Y Heal: ?1mg law. arm.Tlm/ wtn?l? some! hm cu} in ME Ans-?nk! and as of 1min! Malawi)? Lax-l- ero Gm} Nahl? ?lo? Ll4oJms ?llxe (am: and my (IE-men! Am 0? (Nil. 90?? at hand?; Int-laud 01F Stn?rnb Hum col 4a a Ill-r1543: 998?" 5? +1Onk ?50 'fdf' l?l'f?rrn? W19 ??411fr. PLEASE us: THE BACK or THIS roam IF more SPACE I5 NEEDED Relief Requested: - CORRECTIONAL STAFF USE ONLY gm; z/l/zg/n DO NOT WRITE BELOW THIS Ll Received by Vin-mtg" a 7a 3 CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 11/9/2017 Lieutenant/Sergeant or Program Coordinator?s response to grievance/appeal: (1f the initial reaponse is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 1 1/9/17, logged as_ You submitted a medical request slip on 10/27/17 requesting allergy drum and sinus pills for itchy eyes and an itchy, sore throat. The nurse advised you of the results of your doctor visit on 10/4/17, at which time this issue was addressed with the doctor, and no medication was ordered. You again submitted a medical request slip on 11/7/17, wanting to obtain a sinus and cold tablet, and a Xecpenex inhaler. Nursing staff again advised you that the doctor had seen you on 10/4/17, and did not prescribe any medication. Should you have any ?irther questions, feel ?ee to contact the medical unit. 12/08/17 Date Jeffrey L. Ends LPN Printed Name Title Date of response Friday, December 08, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. 4a @190? Champaign County Sheriff's Of?ce Corrections Inmate Grievance Appeal Form 4/ Date: I I 03 I I neaumeo PLEASE wane LEGIBLY Please prin full name Cell Location - If someone helped you complete this form please provide their name: Nature Of Gr ance (only one category per grievance) Staff Conduct El Conditions of Con?nement Medical Dietary Other Disciplinary Appeal I Date of Report Date of Hearing El Grievance Response Appeal. Grievance II This number can be found on the upper right hand corner of the original grievance response Brief Summary of GrievanceHompvov- I $1 I led ovul- Med?gml Venues-I- @nrm -I-o Sam-c. Soc-\- O-C 8? note Meditml-tom (And hunched! Mme, form 5:6 nurse Bream -ii/??hr' . I-au. as 'In oc?m runhave. 4-0 Dot-ir? a $301- Mw?t? Mail Mam-\- La heath-I rim-12A owl- Mme. fu'rm ?Wig. Crimea. 13t- Jro \mex aporomm o-Helu a week moo . Sin-e, didn?Ji- CeMeMIoex because. aha, was So huusu . ?Ins 35"?in CL Shou?m? o5:- NRA . Hum-e. Rwanda. dob is er be, Martini-mm -I-n all Walt on CA ?ii-imam Manner hu?l? has) been 1M o-C 1 a chime WL hex Det?0rmance mu? Medical-r 190$. on NoVewr?Iaer durivxot moth-I; w: i 7 ac PLEAS USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED Relief Requested: I . Tu- m: v1 pukeone Romanov-L ?m od?QcLoUi'e. claims 5 3 DreScriio-e. Mme Swims Meal; Gobi-10W CM- 05 Soon 9.5 onQbI-e or ac-l- Lioux Canvomcmoe, . DO NOT WRITE BELOW THIS LINE - CORRECTIONAL STAFF USE ONLY Received by CZJO 251% Date a Gl?-Lvanoe, Con-Rnwes 390L630. $2 82. mm 4M1. um? faced-inns T?ebtu'xrea, 3m. Madiccd-Kon +0 ?mdivadumls 05; Winmroermhd. 423$ SubwuH Novmbu act?l x} CHAMPAIGN COUNTY CORRECTIONAL CENTER INITIAL RESPONSE TO INMATE Response to grievance number: Date and time Inmate Grievance Appeal From was received by the Corrections Supervisor or Program Coordinator: 12/8/2017 Lieutenant/ Sergeant or Program Coordinator?s response to grievance/appeal: (If the initial response is to be given by the Health Care Authority, document their response.) I have reviewed your grievance dated 12/08/17 logged as- The doctor saw you on 11/14/17, and he diagnosed your condition as Adenitis of the groin, a swollen node. The doctor also ruled out having a hernia. He placed you on an antibiotic twice daily for 7 days, and advised you to apply hot packs to the affected area during this time. Medical records indicate you took the entire antibiotic prescription as directed. There are no records of any requests by you for the prescribed hot packs. The antibiotic is not considered incorrect or ineffective due to your lack of compliance with the doctor?s treatment orders. If you have ?lrther concerns, please ?ll out a medical request slip. g0? 12/12/17 Date Jeff Eads LPN Printed Name Title Date of response Tuesday, December 12, 2017 You may appeal this decision directly to the Jail Superintendent by completing an Inmate Grievance I Appeal Form within 5 days of receiving this response. Please reference the grievance number listed on the top of this response. Grievan Champaign County Sheriff's Of?ce Corrections Division m" Inmate Grievance Appeal Form 1577? 6364/64 Date: I 25 6? I REQUIRED PLEASE WRITE LEGIBLY ~ame=? 1mm" Please print full name Cell Location If someone helped you complete this form please provide their name: Nature Of Grievance (only one category per grievance) Staff Conduct Conditions of Con?nement medical I Dietary El Other Disciplinary Appeal I Date of Report Date of Hearing Grievance Response Appeal. Grievance - This number can be iound on the upper right hand corner of the original grievance response Brief Summary of Grievance: I New 4h?; mrlr?EQ Add: ?hr "vac-heated; egg The Irrtr? TM . are; II MIR- xv fl Ir: 63:;le . . . . . h?w?t? are?" ?g . {meme 1:thth my: c-hl/ lFrI-m-te' I Le: 36.. WI: 4 4 I Elg??h $1194 or cc: eh len 1.4 ?mow? ma; l- I (- flu-*? rItHh?F at: $5 FDAIM eta-me? Iii-up I 31% PLEASE USE THE BACK OF THIS FORM IF MORE SPACE IS NEEDED DO NOT WRITE BEL THIS LINE - CORRECTIONAL STAFF USE ONLY Received by Date