COLUMBIA GIRLS SECURE CENTER
PRE-SHIFT BRIEFING FORM
DATE:
TOUR #1
9:45PM
TOUR #2
5:45AM
TOUR #3
STAFF CONDUCTING BRIEFING (print)
1:45PM
(sign)
POST ORDERS:
AOD:
RESTRAINT MONITOR: 1.
2.
MENTAL HEALTH: __________________________________________
CSU:
Liberty
Opportunity
A:
A:
B:
B:
Responder:
Responder:
Responder:
Responder:
STAFF IN ATTENDANCE:
Print
Sign
Facility Count:
Master:
□
Out (Initials):
Gate (Initials):
IIP’s Reviewed
SPECIAL SUPERVISION STATUS (SW, EBP, SPECIAL PROGRAM):
PHYSICAL RESTRAINTS FROM PREVIOUS SHIFT:
SIGNIFICANT RESIDENT ISSUES:
HEALTH, SAFETY, SECURITY ISSUES: (Locks Broken, Searches Needed, Etc.):
SCHEDULED TRIPS:
SPECIAL INSTRUCTIONS (Medical Care, Visitors, Schedule Changes, Etc.):
NEW ADMISSION(S):