Incident Report - Lee Adjustment Center, CCA, 2004
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PRIVILEGED AND CONFIDENTIAL FORM 5-IA REVISED: 12/01/02 CORRECTIONS CORPORATION OF AMERICA INCIDENT REPORT INCIDENT NUMBER:04-i205-245-I DATE OF INCIDENT:September 14.2004 I. Type of Incident: PRIORITY I q q q q Death - any person Escape Rape (forced sexual assault) Inmate disturbance (major property damage or injury) 0 Loss of firearm q Facility damage (major property damage) q Hostage @king 0 Employee work stoppage q Erroneous release q Work-related accident involving employee injury requiring admission to a hosstai q Other - q PRIORITY II Assault resulting in Serious Physical Injury q Attempted escape q Attempted suicide/self-mutilation requiring treatment or admission to a hospital 0 Discovery of significant amount of drugs, alcohol or controlled substance II. Description of incident: FACILITY:Lee Adiustment Center MILITARY TIME OF INClDENT:approx. 1’925hrs q PRIORITY II (CONTINUED) Interruption of institution services that affect the daily facility operations q Inmate disturbance (no major property damage or injury) 0 Use of force resulting in Serious Physical Injury 0 Firearm discharged q Loss of security keys or any tool that is capable of causing death/ serious physical injury or facilitate an escape q Discovery of ANY firearm/ ammunition q Walk-away 0 Work-related accident involving employee injury requiring outside medical attention 0 Any arrest of any employee/visitor PRIORITY Ill 0 Multiple food illness complaints within 24 hours 0 Work-related accident involving employee injury not requiring medical attention PRIORIN Ill (CONTINUED) 0 Attempted rape (sexual assault) 0 Assault or fight with less than Serious Physical Injury and more than Superficial Injury [7 Use of force resulting in less than Serious Physical Injury and more than Superficial Injury 0 Other - PRIORIN IV 0 Failure to return q Assault or fight with superficial or no injuries 0 Use of force with superficial or no injuries 0 Self-mutilation or an attempted suicide not requiring treatment at nor admission to a hospital 0 Discovery of other potentially dangerous contraband 0 Other - (Include precise location in the facility the incident occurred) On 9114104 at approx. 1925hrs C/O Brian Adkins made a call for assistance on the Lee Adjustment Center Loop /Recreation Yard) and Capt. Harold Kinq radioed for all available units to respond to the Loop. C/O Adkins was workinq the tower on the LOOP when four inmates beqan to tear the tower down with concrete ciqarette butt containers. The inmates proceeded to pull several 2x4 railinqs loose from the tower rails. At this time C/O Adkins began to video the incident. C/o’s Sammy Harold and Greq Ten-v were also assiqned to the Loop, and beqan to qive verbal directives to the inmates to halt the property damaqe. Recreation Coordinator Calr Briscoe was also present on the LOOP monitorinq a horshoe tournament. C/O Monica Davidson was the first responder to arrive at the Loop. Once there C/O M. Davidson took the video camera from C/O Adkins and continued to video the incident. The inmates who were attemptinq to tear down the tower moved to the side of the maintenance buildinq and beqan to use the 2x 4’s in an attempt to qain entry into the masonry room. Capt. Kinq requested that Capt. Nathan Mullins respond with MK9 O.C. foqqers obtained from Senreqation and Central Control. C/O Donald Gabbard and C/O Micheal Cox responded to the Loop. Capt. Kinq and C/O Ten-v attempted to qet the inmates who were vandalizinq the maintenance buildinq to stop at which time the inmates beqan swinqinq the 2x 4’s at them causina the staff to back away. The inmates then told C/O M. Davidson to stop filminq and beqan to chase her off the LOOP swinqinq the 2x4’s at her and demandinq the video camera. The responders then beqan usinq verbal directives to qet the other inmates to exit the Loop. Capt. Kinq told the inmates that if thev let C/O Atkins out of the tower, the staff would leave the Loop. The inmates complied and allowed C/O Atkins to come down from the tower and leave the LOOP. After exitinq the LOOP, the staff locked the seven remaininq inmates who were vandalizing the maintenance buildinq. on the LOOP, and beqan to trv to qet the other inmates to return to their housinq units. C/O Lee Bennett secured the LOOP qate. Capt. Mullins arrived with the MK9 OC foqqers and the videocamera from Seqreqation which he qave to C/O Jason Davidson to beqin filminq. At 1931 hrs, A/W Donna Stivers moved from the Administration buildinq to Central Control, initiated the IMT process and beqan to paqe the SORT Team. IM Stivers radioed an order for all inmates to be placed on lockdown and for all units to radio a status report. Capt Kinq and the respondinn staff beqan cJvinq directives for the inmates on the Vard to return to their units, with no compliance. Capt. Kinq then attempted to instruct the inmates to qo into the West Dorm smokinq area to no avail. The video camera operated bv C/O M. Davidson beqan to stop workinq due to the battetv dvinq. Capt. Kinq then reported that the seven inmates who had been locked on Proprietary Information - Not for Distribution - Copyrighted Page 1 of 6 PRIVILEGED AND CONFIDENTIAL FORM 51A REVISED: 12/01/02 the Loop had used the 2x 4’s to prv the Loop Qate open, had exited the Loop and were beclinninq to break windows in the South Dorm. Capt. Kinq reported approx. thirtv to fortv inmates were trying to climb the North Dorm manaqement fence. Capt Kina then notified IM Stivers that the seven inmates had qotten off of the Loop and that approximatelv 200 to 300 inmates were on the vard refusinq directives and causinq propertv damaqe. IM Stivers then called 911 and notified the dispatch that she needed assistance due to a disturbance. Recreation Coordinator Briscoe went to the Recreation Room and then proceeded to the Recreation Office. C/O M. Davidson. C/O Jason Davidson, C/O Michael Cox. C/O Andy Gabbard and C/O Brian Atkins went to the breakroom in operations (Administrative buildina). The inmates on the vard beqan throwinq rocks at them and breakinq windows in the Administrative buildinq. At approx. 1940hrs. a staff recall was initiated. At 1946hrs N/O Winqs were reported locked down and staff beqan reportinq that fires were beinq set within the institution. C/O M. Davidson advised that a fire had been set in the Administrative buildinq after inmates attempted to break in and net the staff out unsuccessfullv. At approx. 1945hrs Chief Brvon Ponds arrived on arounds. Capt. Mullins and Capt. Kinq beqan to move all vard staff UP the hill towards Centrat Control. Inmates from the West Dorm smokinq area beqan to throw rocks at the staff movina up the hill. At approx. 1948hrs. Capt. Kinq and Chief Ponds entered the armory and beaan issuinq chemical / inflammatory agents to respondinq staff which included A/W David Frye, C/O Richie Woodard, C/O Keith Prvse and Lt. Terry Fultz (with K-9 unit Donya) and Sat. Greg Deaton who was on dutv at the time. At approx. 1950hrs. IM Donna Stivers advised Manaqina Director Melodv Turner that she would be sendinq a response team into the facilitv to rescue staff and that at this time, she was not sure where all staff were located. Radio reports and staff visuals indicated the following staff locations: Maintenance Officer Kris Goldey was located in Maintenance with three inmates, C/O Joann Estes, RN Carolyn McIntosh and RN Arnetta Fuaate were locked inside the medical file room, Canteen Lisa Pearson was locked inside the kitchen, C/O Scott Lvcliter and Sat. Kenneth Snowden were locked in the North Dorm upper staff bathroom, C/O M. Davidson, C/O Jason Davidson, C/O Michael Cox, C/O Andy Gabbard and C/O Brian Atkins were trapped in Operations (Administrative buildinq) and Recreation Coordinator Carl Briscoe was locked in the Recreation Office in the Administration Buildinq. While on the phone with M.elodv Turner, IM Stivers received reports from perimeter that inmates were trvinq to make their way to the perimeter fence. IM Stivers then advised C/O Gary Brandenbura to 40 to the Armory to qet shotquns and to issue them to firearms qualified respondina staff to secure the perimeter. A total of nine shotquns were issued to the perimeter staff. At approx. 1955hrs, IM Stivers sent the response team on clrounds to rescue the remainina staff who were in distress. Melodv Turner advised chemical I inflammatow aqents onlv for the response team. The followinq aqents were authorized to the following staff: David Frye (MK9 Foqqer), Brvon Ponds (MK9 I 515 Triple Chaser CS Grenade), Richard Hobbs (MK9). Richie Woodward (37mm / MK9). Keith Prvse (37mm / MK9), Grew Deaton (37mm Multi-Launcher), Terry Fultz (MK9) - Chemical / lnflammatorv Rounds issued for the 37mm’s included: 565 Scat CS, 501 CS Muzzle Blast, 502 OC Muzzle Blast, 570 CS Short Rancre Speedheat Grenades, 560 CS Lona Ranqe Speedheat Grenades and RB40 Rubber Stinqer Rounds - All MK9’s were OC Foqsers. Upon enterinq the yard and movina down the hill, inmates beqan throwinq rocks, batteries, cans of food, wood and other items at the respondinq staff from the North Dorm smokinq area. The response team observed that the North Dorm smokinq area fence crate was beina breached bv the inmates. The response team’s 37mm’s were fired into North Dorm smokinq area to stop the throwina of obiects and to prevent inmates from advancinq on the response team. 37mm rounds reported fired at this time were: I- CS Muzzle Blast (Sqt. Deaton), l- OC Muzzle Blast (Sqt. Deaton), I- OC Muzzle Blast (C/O Woodward) and I- OC Muzzle Blast (C/O Prvse). Chief Ponds deploved l- 515 Triple Chaser CS crrenade between South Dorm and West Dorm smokinq area due to a lame number of inmates advancing towards the response team and failinq to follow verbal directives. A unidentified inmate picked up a portion of the grenade and threw it back at the response team contaminatinq them with CS. At this time, the response team was forced to return to Central Control because thev were contaminated with the chemical aqent from the qrenade. The response team did not successfully rescue staff on the first attempt due to the chemical / inflammatory aqents being laraelv inneffective. IM Stivers advised Melodv Turner that chemical / inflammatory agents had failed and Melodv Turner approved the use of shotcluns on the yard. At 2015hrs. IM Stivers authorized shotquns loaded with beanbaq rounds only and birdshot in the respondinq staffs pockets that would onlv be used if necessary. Weapons and chemicals for the second response attempt are as follows: David Frve (Shotqun / MK9), Brvon Ponds (Shotgun / MK9), Richard Hobbs (MK9). Ritchie Woodward (37mm I MK9), Keith Prvse (37mm I MK9), Greq Deaton (37mm Multi-Launcher I MK9), Ten-v Fultz (MK9 and K-9 Unit Donva), Marvin Henson (Shotqun) Archie. Moore (Flex-Cuffs) - AA MK9’s were OC Fogaers. Upon enterinq the vard, inmates began to throw rocks, batteries, cans of food, wood and other items at the response team from the North Dorm and West Dorm smokinq areas. The response team’s 37mm’s were fired into the North Dorm smokinq area in order to stop the throwinq of obiects and to prevent inmates from advancinq on the response team. 37mm rounds reported fired at this time were: lCS Speedheat (Sgt. Deaton), I- CS Speedheat (C/O Woodward), I- RB40 Rubber Stinqer Round (C/O Woodward) and I- CS Speedheat (C/O Prvse). At this time, Chief Ponds directed all inmates in the West Dorm smokinq area to set on the ground. The inmates initially complied. Two inmates attempted to qet up off the qround and Chief Ponds depfoved a short burst of OC from his MK9 Foqqer causinq the inmates to complv with directives. At approx. 2020hrs, responders from the second team located Recreation Coordinator Carl Briscoe who then beqan assisting the team. While the inmates were on Proprietary information - Not for Distribution - Copyrighted Page 2 of 6 PRIVILEGED AND CONFIDENTIAL FORM 5-‘IA RRIISED: 1 Z/O1 102 ._ the around; more respondinq staff who had lust arrived at the facilitv beqan to use flex-cuffs to restrain the inmates in the front. Durinq this time, Records Clerk Barbara Estes was brieflv qrabbed from behind bv an unknown inmate and then released. At approx. 2040hrs, due to the smoke from a qarbaqe can fire in KLM Winq (West Dorm). IM Stivers authorized evacuation of KLM into the hallwav of West Dorm. Durinq the evacuation, an inmate attempted to strike Sqt. James Withers with a closed fist. Sqt. Withers struck the inmate with his hands in order to defend himself. Also at approx. 2040hrs. the team radioed that C/O M. Davidson, C/O Jason Davidson. C/O Michael Cox, C/O Andv Gabbard and C/O Brian Atkins had been rescued from Operations (Administration buildinq). C/O M. Davidson and C/O J. Davidson had taken the tapes out the video cameras and put them in their pockets, leavinq the cameras on the tables in Operations due to the inmates earlier statements about wantinq the cameras. At approx. 2047hrs. the response team reached the sidewalk bv the kitchen and ordered the inmates present to lav on the qround. Sqt. Deaton spraved a 1 second MK9 OC Foqqer burst at the qround due to noncompliant inmates attempting to rise to their feet after initiallv lavinq on the qround. At approx. 2048hrs. AW Frve .radioed that he had rescued Lisa Pearson from the kitchen and that the team must qo to North Dorm to net staff in the Upper North bathroom due to distress calls over the radio. Also at approx. 2048hrs, perimeter advised that there were ‘inmates close to the perimeter fence. IM Stivers advised that if inmates attempt to climb the fence, to use what force is necessary to prevent escape (Vice President Operations Jimmv Turner verballv qave IM . Stivers that directive bv phone). At 2058hrs, IM Stivers advised the response team to qo to the North Dorm staff bathroom to retrieve the two staff members trapped in the Upper North staff bathroom. Once the team entered the North Dorm, AiW Frve and one team entered one side of the dorm and Chief Ponds and a second team entered the other side of the dorm. Inmates were qiven directives to qet on the floor and submit to cuffs while staff beqan to place flex-cuffs on them. Once the lower floor was under control, the two teams moved to the upper floor and initiated the same process. After securinq the top floor, C/O Scott Lvcliter and Sat. Kenneth Snowden were rescued from the North Dorm Upper staff bathroom. At approx. 2102hrs Chief Ponds, AiW Frve and Lt. Fultz entered the West Dorm and placed handcuffs on an inmate that was discharqinq two fire extinquishers in N davroom. At approx. 2104hrs. a mild explosion was reported in the area of the Chaplain’s office. At 2108hrs. KSP arrived and beqan to provide perimeter support. Response teams called in to Central Control and advised that all North Dorm inmates were beinq restrained and that the dorms were beinq brouqht under control. At this time, staff advised that thev needed to evacuate North Don-n due to the fire in the Administration buildinq. IM Stivers approved for the North Dorm inmates to be evacuated into the qrassy area beside medical after thev had been restrained. Inmates from the North Dorm were evacuated, escorted to the qrassv area and instructed to sit down in the grass. At approx. 2115hrs C/O Vickv Bennett went to the main qas shut off valve and cut off qas to the facilitv to prevent an explosion. At approx. 2119hrs. Archie Moore advised that he had retrieved C/O Joann Estes. RN Carolvn McIntosh and RN Arnetta Fuqate from medical. At approx. 2122hrs. while assistinq in escortinq inmates from the North Dorm to the qrassv area beside medical, C/O Richie Woodward discharqed a 1 second MK9 OC Foqqer burst towards an unidentified non-compliant inmate and accidentallv contaminated C/O Pryse and C/O Steve Turner. Also at approx. 2122hrs. C/O Greqq Bowlinq discharqed a 1 second MK9 OC Foqqer burst into the air above the qrassv area to qain compliance from North Dorm inmates who were standinq up and refusinq to sit down. At approx. 2123hrs a perimeter fence check was completed and the perimeter fence was reported to be intact with no breaches. At 2124hrs. inmates were reported to be breakinq windows out of West Dorm cells. At approx. 2130hrs. Maintenance Officer Kris Goldev was retrieved by members of the. response team. At approx. 2134hrs, several small explosions were reported from the canteen. Followinq the sucessful evacuation of North Dorm, several of the respondinq staff beqan to conduct the same handcuffinq process in the South Dorm that had been used to restrain the North Dorm. It was observed bv the response team that a portion of the South Dorm smokinq area fence had been pulled away from the around. At 2149hrs. staff advised that all dorms were under control, all inmates were restrained and preparation for an institutional count was initiated. At 2150hrs. all staff were accounted for. At 2153hrs an institutional count was conducted. At 2214hrs. the Fire Department arrived with thirty members to attempt to contain the various fires. At 2241hrs, the canteen fire was reported to be under control. At approx. 2225hrs. twentv-one Eastern Kentucky Correctional CERT team members arrived at the facilitv. At approx. 2320hrs. six Marion Adiustment Center SORT members arrived at the facilitv and at approx. 2325hrs eleven Otter Creek Correctional SORT members arrived at the facilitv. At approx. 2327hrs. all CERT and SORT members entered the vard and beqan assistins with escortinq the inmates from the qrassy area to West Dorm. At approx. OOOOhrs, four more Marion Adiustment SORT members arrived to assist. At approx. 0030hrs. Manaqinq Director Melody Turner alonq with five Metro-Davidson SORT members arrived. At approx. 0141 hrs. after all fires were under control, .all fire fiqhters exited the facilitv and Beatvville Police Department entered the faciiitv. At 0224hrs, a second qroup of five Metro-Davidson SORT arrived. At 0334hrs. all kevs and radios were accounted for. At 0330hrs, all inmates were secured in West Dorm. At 0337hrs. an Institutional Book (ID) Count was conducted. At 0356hrs, the Institutional Book Count was cleared. At 0348hrs, all masonrv tools were accounted for. Correctional Officer Brian Adkins was sent directlv to the local hospital by LAC medical due to lacerations to his hand from an earlier attempt to break out a window while trapped in Operations and was treated and released. Inmate Stratton, Jeffrev #330019 was sent to the local hospital with a broken riqht thumb and was later admitted. Inmate Bruce, Darrell #312834 was sent to the local hospital with a lacerated left index finqer and was Proprietary Information - Not for Distribution - Copyrighted Page 3 of 6 FORM 5-1A PRIVILEGED AND CONFIDENTIAL REVISED: 1 i101102 not admitted. Carl Brisoe received a cut to his riqht hand that did not. require . . ^outside medical assistance. Total chemical -_A or 570 CS Speedheat Grenades, lmunitions reported deployed bv the first arid second response team rncluae: Y- stju CS Grenade, l- RB40 Stinqer round luzzle Blast Round, I515 Triple Chaser 501 CS Muzzle Blast Round, 3- 502 OC N . . . Listed below are the inmates who were and several MK9 OC Foqqers. Ali chemical munitions were used OUtdoors. placed in seqreqation from September 14, 2004 throuqh September 26. 2004 for involvement / investiqation of involvement in the disturbance. The staff listed are those staff who were directlv involved in the initial incident I response. Ill. inmates involved: (Placd in I” box: W for witness or P for participant ) (Place in 2”* box: S for written statement and R for refused to give written statement) # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # Tavtor, Bobbv Hurst, Joel Moore, Samuel Talbert. Damon Estepp. Eddie Mears, Jason Porter, Gordon Boivin, Dan Bailev, Kenneth Luko, Jeremiah Francis, Randy Inqerson, James Stratton, Jeffery Gillean, Scott Russin, Jason Landrv, Wesley Lindsay. Isaac Touzin, Steven Marallo. Eric C’Mallev, Robert Jenninqs. Jeremy North, James Church, Lvnn Bentlev, Grant Smith, Chancev Thompson, Willie Baker, Grant Howard, Kevin Howard, Jesse White, Cameron Morris, Chad Chamberlain, Michael 164811 141737 140906 159334 142001 262928 319402 330167 259330 315469 322332 330071 330019 330074 280538 330161 330125 315474 296048 330092 262927 276849 259332 305942 315944 330209 287782 127225 330121 141975 330077 330195 Staff involved: (Place in box: W for witness or P for participant) Stivers, Donna Frve. David Ponds, Brvon Moore, Archie Atkins, Brian Herald, Sammy Terry, Greg Davidson, Monica Mullins, Nathan Kinq, Harold Davidson, Jason Cox, Michael Title Title Title Title Title Title Title Title Title Title Title Title Assistant Warden Assistant Warden Chief of Securitv lnvestiqator Correctional Officer Correctional Officer Correctional Officer Correctional Officer Captain Captain Correctional Officer Correctional Officer Proprietary Information - Not for Distribution - Copyrighted Page 4 of 6 FORlVi 5-1A PRlVlLEGED AND CONFIDENTIAL Gabbard, Andy Woodward. Richie Prvse, Keith Goldv, Kris Estes. Joann McIntosh. Carolvn Fuqate, Ametta Pearson, Lisa Lvcliter. Scott Snowden, Kenneth Brisoe. Carl Brandenburq, Gary Hobbs, Richard Deaton. Greq Henson, Marvin Bowiinq. Greg Estes. Barbara Turner, Steve Withers, James Fultz. Tenv Donva REVISED: 12101102 ^ Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title Title 5 Yes q No Staff involved using force: Ponds, Brvon Frye, David Hobbs, Richard Woodward. Richie Ptyse, Keith Deaton, Greq Fultz. Terrv Henson. Marvin Moore, Archie Bowlinq. Greqg Withers, Harold Justification for use of force: q Self defense or defense of a third party q Enforce institution rules and regulations If yes? Title If planned, person authorizing: Melodv Turner Type of Force - Check all that apply 5 Chemical Agents q Physical Handling q Restraint Equipment 0 Straight Batons Enteen (Kitchen) Worker Correctional Officer Serqeant Recreation Coordinator Correctional Officer Lieutenant Serqeant Correctional Officer Correctional Officer Records Correctional Officer Serqeant Lieutenant K-9 Unit q YesM No 5-I C attached from all involved staff and inmates? IV. Was force used in this incident? Correctional Officer Correctional Officer Correctional Officer Maintenance Officer Correctional Officer RN q 0 Spontaneous Planned Manaqinq Director, Division II Chief of Securitv Assistant Warden Lieutenant Correctional Officer Correctional Officer Serqeant Lieutenant Correctional Officer lnvestiaator Correctional Officer Serqeant q q 0 Deadly Taser Inflammatory Agents [XI oc 0 oc/cs 0 Physical 0 Electronic Stun Shield q Other S.I.M.3 - Stinqers 5 Halt destruction of property 5 Quell a disturbance q Prevent escape 0 O t h e r What steps less than force were attempted? (Spontaneous, verbal command, IPC, show of force, etc.) Numerous verbal commands bv on dutv and respondinq staff combined with show of force. q Yes 0 No If yes, 0 Commercial q Homemade Were weapon(s) used by inmate(s) involved? Description of weapon(s): concrete ciqarette butt containers, 2x4 wooden rails, broomsticks, stolen box-cutters ant other assorted makeshift weapons were used by inmates - Note: several homemade knives / homemade hatche were stolen from the Traininq Room contraband board. Proprietary Information-Not for Distribution - Copyrighted Page 5 of 6 FORM 5-1A PRIVILEGED AND CONFIDENTIAL REVISED: 1 Z/01/02 Current location of weapon(s): The orocess of recoverinq all weapons continues - The homemade hatchet was recovered on September 15. 2004 followinq a search of the qrounds. Several of the homemade knives were located in the Administration buildinq followinq a search. V. Were all participants (staff and inmates) evaluated by medical staff? q Yes q No If yes, are all completed medical evaluatioris attached? 0 Yes q No If no, explain: Still awaitinq completion of evaluations. Some inmates were transported to other facilities prior to medical evaluations beinq performed. . Did injuries occur? q Yes q No Hospital admission? q Yes q No If injuries occurred, list name (employee, inmate, or civilian) and nature of injury: Brian. Adkins (Correctional Officer) lacerated hand, Briscoe. Carl (Correctional Officer) - lacerated hand, Stratton, Jeffrev (330019) - broken riqht thumb was admitted to ithe hospital, Bruce, Darrell (312834) lacerated left index finqer VI. Was the incident videotaped? q Yes 0 No Camera operator: Correctional Officer Brian Atkins, Correctional Officer Monica Davidson and Correctional Officer Jason Davidson If no, explain why it was not videotaped: Were photographs of injuries, contraband, or property damage taken? q Yes q No If yes, number of photographs taken? 66 photoqraphs (6 Polaroid and 60 diqital) I videos were taken bv respondinq staff and investiqatinq staff VII. Was there any evidence recovered during the incident? q Yes 0 No Was chain of custody maintained? q Yes q No Description of evidence recovered: photoqraphs of concrete ciqarette butt containers, 2x4 wooden rails, broomsticks, stolen box-cutters and other assorted makeshift weapons were used bv inmates - Note: several homemade knives / homemade hatchet were stolen from the Traininq Room contraband board. Current location of evidence: internal Affairs Office Criminal charges? q Yes [17 No Pendinq completion of the investiqation. Staff member who recovered the evidence (include title): Various VIII. Inmate disciplinary charges filed? Segregation and/or Pre-Hearing Detention Inmate Disciplinary Charqes Pendinq lnvestiqation q Yes q No q Yes q No # #---.. Were property inventories completed on all inmates segregated? [x1 Yes q No I X . Notifications that were made: Warden Assistant Warden of Operations Assistant Warden of Programs Chief of Security Assistant Chief of Security Divisional Health Manager (Death Only) Divisional Managing Director (Priority I & II) Contract Monitor Notification(s) of outside agencies: If Yes must list agency and time [XI Yes q No 0 N/A Time: apDrox. 1940hrs By: Donna Stivers H Yes fl No 0 N/A Time: On-Site By: m By: Donna Stivers ixI Yes 0 No q N/A Time: approx. 1930hrs q Yes q No q N/A Time: approx. 1930hrs By: Donna Stivers By: m B ;;; 00 F q N/A Time: m By: N/A o H N/A Time: N/A [XI q Yes 0 Yes No q 0 N/A Time: aDprox. 1940hrs No 0 N/A Time: 2 Duty Officer: Donna Stivers By: David Frve By: C/O Vicky Bennett Name: Clarke Taylor [KY) Kevin Oddv (VT1 By: Donna Stivers :,y; ro~,~;5hrso N/A Time: approx. 1945hrs RR KDOC, Kentucky State Police, Local Police and Fire Department contact was constant throunhout incident PREPARED BY: Archie Moore POSITION: Facility Investiqator DATE & TIME: September 29,2004 1200hrs SIGNATURE: Proprietary Information - Not for Distribution - Copyrighted Page 6 of 6