CRC Initial Intake and Orientation Form

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IDAHO DEPARTMENT OF CORRECTION CRC Initial Intake and Orientation Form Inmate's Name: IDOC#: Facility Intake Section: Location: ❑ EB-CRC ❑ IF-CRC ❑ N-CRC ❑ PWCC-CCU ❑ SICI-CRC ❑ TF-CRC Transfer Type: ❑ Resident Worker ❑ Rider ❑ Work Release Is the resident able to read and write? Does the resident speak English? Explain, discuss, point out, or provide pursuant to the SOP. (Initial each as completed) Facility emergency procedures: Location of fire extinguishers: Location of first aid kits: Location of evacuation plans: Property management procedures: Employment procedures: Visiting procedures: Healthcare procedures: Inmate funds management procedures: Access to policies and forms procedures: Bed assignment procedures: Laundry procedures: Inmate Emergency Data Form: Current photo: Insert#of and/or item(s) provided Linens: (Sheets ) (Blanket ) Hygiene items: CRC living guide: Findings, concerns, issues documented as C-note entry: ❑ Yes ❑ No ❑ N/A Inmate Acknowledgment and Agreement I have received the community release center(CRC) orientation and intake information and items listed above. I understand that policies, standard operating procedures (SOPs), and facility field memorandums (FMs)that are allowed for inmate disclosure, are available to me or for my viewing upon request. I agree to abide by all of the CRC rules and instructions given to me by staff during this orientation and while housed at the CRC. I have been provided a copy or access to a copy of the CRC living guide. I agree that it is my responsibility to read, understand, and abide by all of the rules or procedures outlined in the living guide. I agree that if I do not understand anything from my orientation or the contents of the living guide it is my responsibility to seek clarification from staff or another resident. Inmate's Signature Date Facility Intake Staff's Name and Associate Number Date (Note: When this section of the form is fully complete per the SOP, forward it to the case manager for further processing.) Inmate's Name: IDOC#: 301.04.03.001 Page 1 of 2 (Last updated 03/13/2017)