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UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed) <br />Personal Hygiene <br />Are toiletries provided to indigent prisoners at no cost? <br />C Yes C No <br />Are the following available at no cost: <br />Soap? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C Yes <br />(^ No <br />Toothpaste? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C Yes <br />C No <br />Razors? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C Yes <br />C No <br />Shampoo? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C Yes <br />C No <br />Sanitary Napkins? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C Yes <br />C No <br />Tampons? <br />C Yes <br />C No <br />If No, are all prisoner charged the same fee? <br />C' Yes <br />C No <br />Do all prisoners have 24-hour access to an operable toilet? <br />C Yes C No <br />Do all prisoners have 24-hour access to a washbasin with hot and cold running water? <br />C Yes f No <br />Physical Facility and Equipment <br />Is the facility kept clean and in good repair? <br />C Yes C No <br />Is all facility equipment in proper working order? <br />C Yes C No <br />Is there any evidence or sign of mold? <br />C' Yes C No <br />Is there any evidence or sign of insects? <br />C Yes C No <br />Is there any evidence or sign of rodents? <br />C Yes C No <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 />UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed) <br />Form USM-218 <br />Page 22 of 27 Rev. 02/25 <br />