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UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed) <br />Has the facility had an audit conducted by a DOJ certified PREA auditor within the past 3 years? <br />r Yes �' No <br />If 'No'to the previous question, has a DOJ PREA audit been scheduled? <br />(- Yes (' No <br />If Yes, what is the scheduled DOJ PREA Audit Date? <br />I- If 'Yes' to the previous question, is a hard copy of the PREA audit available? <br />(' Yes r No <br />If'Yes', Audit Date What was the name of the Auditor? <br />If an audit was conducted, how many deficiencies were noted in the last PREA audit? I I <br />If there were deficiencies, is there a corrective action plan in place? <br />(' Yes (' No <br />If Yes, has corrective action taken place? <br />(- Yes r No <br />Reason for not scheduling a PREA audit: <br />n Expense of PREA Audit <br />❑ Expense of constructions upgrades <br />❑ Expense of Technology upgrades <br />❑ Unaware of requirement <br />❑ Previous PREA audit failure <br />HEALTH CARE <br />Intake Screening <br />Does the facility have a designated health authority with responsibility for health care services? <br />(' Yes (' No <br />Does the facility have policy or procedures for medical, mental health, and dental health screening during intake? <br />(' Yes (' No <br />Do all prisoners undergo medical screening during the initial intake process? <br />C Yes (' No <br />If 'No', how long after intake does the medical screening occur? <br />months days <br />NOTICE: This -document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL Information <br />which is for the sole use of the intended recipient(s). Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended <br />recipient- please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used <br />only to aid in providing healthcare services to federal prisoners. Any other use Is a violation of Federal HIPAA Law and/or the Privacy Act and will be <br />reported as such. <br />UNCLASSIFIEDI/LAW ENFORCEMENT SENSITIVE (When Completed) <br />Form USM-218 <br />Page 11 of 27 Rev. 02125 <br />