HomeMy WebLinkAboutUNITED STATES DEPARTMENT OF JUSTICE, MARSHALS SERVICEA-2020-201-03
U.S. Department of Justice Office of Detention Services
United States Marshals Service Intergovernmental Agreement
Prisoner Operations Division
1. Agreement Number 2. Effective Date
3. Facility Code(s)
4. UEI Number
12-94-0006 August 1, 2025
OFK
KZE9G2M4GRX9
5, Issuing Federal Agency
6, Local Government
United States Marshals Service
SANTA ANA CM JAIL
Prisoner Operations Division
62 CIVIC CENTER PLZ
Office of Detention Services
SANTA ANA, CA 92701
CG-3, 3' Floor
Washington, DC 20530-0001
Tax ID#: 95-6000785
7. Appropriation Data
8, Local Contact Person:
Jaime Manriquez
E-mail:
imagriouez@santa-ana c ;.a
15-1020/XD
Telephone:
(714) 245-8123
9. Services
10. Estimated Number
11. Per Diem
12. Period of
of Federal Beds
Rate
Performance
This agreement is for the housing, safekeeping, subsistence,
Male: 374
and care of Federal prisoners, in accordance with content set
Female: 128
$154.00
Perpetual
forth herein.
Juvenile: 0
Total: 502
13. Guard Trans ortation Hourly Rate
14. Optional Guard/Transportation Services
Guard/Transportation Hourly Rate: $70.00
® Medical
Mileage shall be reimbursed by the Federal Government at the
® U.S. Courthouse
current General Services Administration (GSA) Federal Travel
Regulation Mileage Rate.
JPATS
Encompassed VTC
❑ Video Teleconferencing (VTC) Hearings
15. Department of Labor Wage Determination
Wages Incorporated If
Collective Bargaining Agreement k 2025-323, 2025-324,
® Other HospitalizationHospitalizatiorif Maximum 12hrs Stationary Guards
2025-325,2025-326
16. Local Government Certification
17. Signature of Person Authorized to Sig
To the best of my knowledge and belief, information
(Lo I)
submitted in support of this agreement is true and correct.
This document has been duly authorized by the governing
Signature
authorities of their applying Department or Agency State or
County Government and therefore agree to comply with all
_
��
provisions set forth herein this document.
Print Name
Title Date
18.Federa[ Prisoner Type
19. Other Authorized
20. Signature of Person Authorized to Sign (Federal)
Authorized
Agency User
TlFFANI EASQN Digitallysigned byTIFFANI EASON
Date: 2025.07.30 11:13:08
❑ Adult Male
0 BOP
-04'00'
0 Adult Female
❑ ICE
Signature
❑ Juvenile Male
❑ Other
Tiffanl Eason
Print Name
❑ Juvenile Female
A Chief, Intergovernmental Agreements
Title Date
Page 1 of 18
IGA Agreement Form (REV. 4/2025)
A►-2020-201-03
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written_
4TE �.A> CITY OF SANTA ANA
HAI ALVARO NUNEZ
City Manager
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By:
I" -
TAMARA BOGOSIAN
Senior Assistant City Attorney
RECOMMENDED FOR APPROVAL:
ROBERT RODRIGUE
Chief of Police
Agreement Number 12-94-0006
Table of Contents
Section Description
Page Number
1. Authority................................................................................................................... 3
2. Purpose..................................................................................................................... 3
3. Administration............................................................................................................ 3
4. Place of Performance................................................................................................... 5
5. Agreements Specialist................................................................................................. 5
6. Termination............................................................................................................... 5
7. Assignment and Outsourcing of Jail Operations............................................................... 6
8. Medical Services......................................................................................................... 6
9. Affordable Care Act (ACA)............................................................................................ 7
10. Receiving and Discharging of Federal Prisoners..............................................................8
11. Prisoner Work Program.............................................................................................. 8
12. Guard/Transportation Services to/from Medical Facility...................................................9
13. Guard/Transportation Services to/from U.S. Courthouse ............................................... 10
14. Guard/Transportation Services to Justice Prisoner & Alien Transportation System (]PATS) or
Other.......................................................................................................................... 10
15. Video Teleconference Hearing within the Facility.......................................................... 11
16. Optional Guard Services to Video Teleconference Hearing within the Facility .................... 11
17. Special Notifications................................................................................................ 11
18. Body Worn Camera Information Requests................................................................... 12
19. Restrictive Housing and Suicide Prevention................................................................. 12
20. Prison Rape Elimination Act(PREA)............................................................................ 13
21. PREA Prisoner Incident Reporting.............................................................................. 13
22. Federal Acquisition Regulation (FAR) Agreement Provisions ........................................... 14
23. Guaranteed Minimum Bed Space............................................................................... 15
24. Economic Rate Adjustments...................................................................................... 15
25. Billing and Financial Provisions..................................................... ...... 16
.......................
26. Payment Procedures................................................................................................ 16
27. Hold Harmless........................................................................................................ 17
28. Disputes................................................................................................................ 17
29. Review of Services.................................................................................................. 17
30. IGA Amendments.................................................................................................... 17
31. Litigation........................................................................................ ..... 18
..................
32. The First Step Act.................................................................................................... 18
Page 2of18
Local Government (initial): �
Federal Government (initial).
Agreement Number 12-94-0006
1. Authority
Pursuant to the authority, 1061h Congress Public Law 553, Section 119 of the "Department of
Justice Appropriations Act, 2001", this Intergovernmental Agreement (hereinafter referred to as
"agreement") is entered into between the United States Marshals Service (USMS) (hereinafter
referred to as the "Federal Government") and Santa Ana City Jail (hereinafter referred to as
"Local Government"), who hereby agree as described in this document.
2. Purpose
The Federal Government and the Local Government establish this agreement allowing the USMS
or other authorized agency user as noted in block #19, page one (1) of this agreement to house
individuals detained on federal charges or federal court orders (hereinafter referred to as "Federal
prisoners") with the Local Government at the Santa Ana City Jail; 62 Civic Center Piz, Santa
Ana, CA 92701 (hereinafter referred to as "the Facility") designated in block #6 on page one (1)
of this agreement.
3. Administration (October 2021)
The Local Government shall provide for the secure custody, safekeeping, housing, subsistence,
and care of Federal prisoners in accordance with all state, local, and federal laws, standards,
regulations, policies, and court orders applicable to the operation of the Facility. Federal
prisoners shall be housed in a manner consistent with the Federal Performance Based Detention
Standards (FPBDS) subset utilized by the USMS Detention Facility Review Program. These
standards are set forth in Form USM-218 (provided as an attachment to this
agreement). Facilities shall follow the current standards summarized in Form USM-218 and any
other standards required by an authorized agency whose prisoners are housed by the Local
Government pursuant to this agreement. Full text of the FPBDS can be found at:
htta://wwwASD.usmarshals.ciov/prisoner/detention-standards.htm as an additional reference
source for best practices.
Santa Ana City Jail shall comply with Congressional mandates, federal laws, Executive Orders
and all existing Santa Ana City Jail policies. Santa Ana City Jail shall provide a means for
verification of any state inspections, accreditation, and, if applicable, any alternative correctional
facility accreditations such as an accreditation from the American Correctional Association
accreditation.
The USMS ensures the secure custody, care, and safekeeping of USMS prisoners. Accordingly, all
housing or work assignments, and recreation or other activities for USMS prisoners are permitted
only within secure areas of the building or within the secure external recreational/exercise areas.
All work assignments for unsentenced Federal prisoners must be voluntary.
The Local Government shall conduct initial and periodic background and reference checks of
applicants, employees, contractors, and volunteers. All allegations of staff misconduct shall be
investigated and reported to law enforcement as appropriate. Staff misconduct involving or
affecting USMS prisoners shall be reported to the local district United States Marshal (USM), Chief,
Page 3 of 18 ��
Local Government (initial).
Federal Government (initial): 7—
Agreement Number 12-94-0006
or their designee and to the USMS Prisoner Operations Division (POD) at
PODCoCInquiries@usdoygov.
At all times, the Federal Government shall have access to the Facility and to the Federal prisoners,
and to all records pertaining to this agreement, including financial records, for a retention period
of three (3) years from the date of request by the Federal Government.
The Local Government shall maintain written policies and procedures that describe all facets of
facility operations, maintenance, and administration. The Local Government shall maintain written
contingency and emergency plans for situations including but not limited to riots, hunger strikes,
disturbances, escapes, hostage situations, and mass prisoner relocation.
The Local Government shall maintain records of annual fire safety inspections. The Local
Government shall maintain dangerous materials in accordance with government regulations.
The Local Government shall maintain an objective review, classification, and housing process.
Federal prisoners shall be clearly identified as USMS prisoners in the classification system.
The Local Government shall ensure Federal prisoners under the age of 18 receive an age -
appropriate diet, exercise, and education.
The Local Government shall ensure Federal prisoners under the age of 18 or charged as a juvenile
shall be separated by sight and sound and out of regular contact with adult prisoners, except in
emergency situations or approval from the court.
The Local Government shall keep the Facility clean and in good repair. Food service equipment
shall meet established health and safety codes. The Local Government shall provide a minimum
of three (3) meals per day that are varied and nutritionally adequate.
The Local Government shall provide safe and clean space and items for proper prisoner hygiene.
The Local Government will provide clean and serviceable bedding and clothing. Clothing and shoes
shall be properly sized and temperature and weather appropriate. The Local government shall
provide appropriate attire upon release.
The Local Government shall properly inventory, store, and return prisoner property upon release.
The Local Government shall provide adequate accommodations for prisoners with disabilities once
accepted by the Local Government.
The Local Government shall prohibit discrimination on the basis of disability, race, sex, sexual
orientation, religion, and national origin in the provision of services, programs, and activities.
The Local Government shall provide prisoners with reasonable opportunities to participate in
religious practices, exercise, and access to mail, telephones, personal legal materials and legal
reference materials or confidential counsel.
The Local Government shall maintain a grievance program with at least one level of appeal. The
grievance procedures shall be made available to prisoners.
(End of Provision)
Page 4 of 18
Local Government (initial): Q.IL.
Federal Government (initial): T€—
Agreement Number 12-94-0006
4. Place of Performance (May 2021)
The principal place of performance for this agreement shall be:
Santa Ana City Jail; 62 Civic Center Piz, Santa Ana, CA 92701
(End of Provision)
S. Agreements Specialist (November 2021)
The Contracting Officer (KO) may designate in writing one or more government employees, by
name and position title, to act for the KO under this agreement. Each designee shall be identified
as an Agreements Specialist. Such designation(s) shall specify the scope and limitations of the
authority so delegated; provided, that the designee(s) shall not change the terms or conditions of
the agreement, unless the Agreements Specialist is a warranted KO, and this authority is delegated
in the designation.
The Agreements Specialist is:
Name: Tiffani Eason
Title: A- Chief, Intergovernmental Agreements Branch
Contact Information: (703) 740-8442
(End of Provision)
6. Termination (May 2021)
The agreement can be terminated by either party for any reason. The requesting party, requester,
seeking to terminate this agreement may do so by providing a written notice to the receiving
party, requestee, at least thirty (30) calendar days in advance of the proposed termination date.
An exception is made when an emergency situation requires the immediate relocation of Federal
prisoners.
In order for the Local Government to initiate a termination of this agreement, the Local
Government must:
a. As noted in this section, paragraph one above, the Local Government shall provide
the Federal Government via the KO or designee a written notification by email at
least thirty (30) calendar days in advance of the potential termination date unless an
emergency situation requires the immediate relocation of Federal prisoners.
b. The Local Government shall provide adequate time, if applicable, for the Federal
Government to transport and relocate Federal prisoners. Based on the number of
Federal prisoners at the facility, a thirty (30) day notice may not be adequate to
vacate the premises; thus, the Local Government shall agree to provide the Federal
Government a reasonable time frame to exit the facility.
c. The Local Government shall work with the Federal Government to locate alternative
housing solutions for the Federal prisoners.
Page 5 of 18
Local Government (initial): 0-2-
Federal Government (initial): gam_
Agreement Number 12-94-0006
d. The Local Government may not request rate or per -diem increases once the Local
Government has provided a termination notice to the Federal Government and the
Federal Government has acknowledged the receipt of before mentioned notice.
Where the Local Government has received a cooperative agreement through the POD's
Cooperative Agreement Program, the cooperative agreement termination and other applicable
provisions shall:
a. be incorporated into this agreement;
b. survive after the expiration of the cooperative agreement; and
c. supersede the termination provisions of this agreement.
(End of Provision)
7. Assignment and Outsourcing of ]ail Operations (May 2021)
The overall management and operation of the Facility housing Federal prisoners shall not be
contracted out without the prior written notification of the Federal Government.
(End of Provision)
S. Medical Services (May 2021)
The Local Government shall maintain written procedures that describe actions taken in the event
of a prisoner's death, assault, or medical emergency to include notification to the USMS.
The Local Government shall provide a medical and mental health screening upon admission to the
Facility. The Local Government shall inform prisoners how to access health services.
The Local Government shall notify the local USMS district office of a—Y infectious disease outbreak.
The Local Government shall provide Federal prisoners with the same level and range of care inside
the Facility as that provided to state and local prisoners. The Local Government is financially
responsible for all medical care provided inside the Facility to Federal prisoners. This includes the
cost of all medical, dental, and mental health care as well as the cost of medical supplies, over-
the-counter medications and any prescription medications routinely stocked by the Facility. The
Facility is encouraged to purchase non -OTC medications for USMS prisoners through the USMS'
National Managed Care Contract (NMCC) Discount Pharmacy Program. When possible, generic
medications should be prescribed. The cost of all of the above -referenced medical care is covered
by the Federal per -diem rate. The Federal Government will pay for the cost of specialized medical
services not routinely provided within the Facility, such as dialysis.
The Federal Government is financially responsible for all medical care provided outside the Facility
to Federal prisoners. The Federal Government must be billed directly by outside medical care
providers pursuant to arrangements made by the Local Government for outside medical care. The
Local Government shall utilize outside medical care providers that are covered by the USMS' NMCC
Preferred Provider Network to the maximum extent practicable. The Local Government can obtain
information about NMCC covered providers from the local USMS District Office. The Federal
Page 6 of 18
Local Government (initial): U_
Federal Government (initial): TE
Agreement Number 12-94-0006
Government will be billed directly by the medical care provider not the Local Government. To
ensure that Medicare rates are properly applied, medical claims for Federal prisoners must be on
Centers for Medicare and Medicaid Services (CMS) Forms so that they can be re -priced to Medicare
rates in accordance with the provisions of Title 18 U.S.C. Section 4006. The USMS will not
reimburse the detention facility for medical payments made on behalf of USMS prisoners in the
absence of a specific arrangement approved in writing by the USMS.
All outside medical care provided to Federal prisoners must be pre -approved by the Federal
Government except in a medical emergency. In the event of an emergency, the Local Government
shall proceed immediately with necessary medical treatment. The Local Government shall notify
the Federal Government immediately regarding the nature of the Federal prisoner's illness or injury
as well as the types of treatment provided.
The Facility shall have in place an adequate infectious disease control program which includes
testing of all Federal prisoners for Tuberculosis (TB) in accordance with National Commission on
Correctional Health Care (NCCHC) Standards for Health Services in Jails. TB testing shall occur
with 14 days of intake (unless current TB tests results are available), be promptly documented in
the Federal prisoner's medical record and the results forwarded to the local USMS District within
thirty (30) days of intake. Special requests for expedited TB testing and clearance (to include time
sensitive moves) shall be accomplished through advance coordination by the Federal Government
and Local Government.
The Local Government shall immediately notify the Federal Government to include the local district
office of any cases of suspected or active TB or any other highly communicable diseases such as
but not limited to Coronavirus Disease (COVID), severe acute respiratory syndrome (SARS), Avian
Flu, Methicillin-Resistant Staphylococcus Aureus (MRSA), Chicken Pox, etc., which might affect
scheduled transports or productions.
When a federal prisoner is being transferred or released from the Facility, they will be provided
with a minimum of seven (7) days of prescription medications and any medications already
dispensed to the prisoner. Medical records and Form USM-553, Prisoner in Transit Medical
Summary must travel with the Federal prisoner. If the records are maintained at a medical
contractor's facility, it is the Local Government's responsibility to obtain them before a federal
prisoner is transferred.
Federal prisoners may be charged a medical co -payment by the Local Government in accordance
with the provisions of Title 18 U.S.C. Section 4013(dl. The Federal Government is not responsible
for medical co -payments and shall not be billed if the federal prisoner is indigent and cannot make
the co -payment. Indigent Federal prisoners shall not be denied medical evaluation and treatment
for failure to provide a co -payment.
(End of Provision)
9. Affordable Care Act (ACA) (May 2021)
Upon release of a Federal prisoner, the Local Government shall provide information regarding
the Affordable Care Act (ACA). The ACA website is located at:
http://www.hhs.gov/healthcare/about-the-aca/index.html.
(End of Provision)
Page 7 of 18 ILJ2.
Local Government (initial):
Federal Government (initial): T
Agreement Number 12-94-0006
10. Receiving and Discharging of Federal Prisoners (May 2021)
The Local Government agrees to accept Federal prisoners only upon presentation by a Law
Enforcement Officer (LEO), USMS Task Force Officer (TFO) or a USMS designee with proper
credentials.
The Local Government shall not relocate a Federal prisoner from one facility under its control to
another facility not described in this agreement without permission of the Federal Government.
Additional facilities within the same agreement shall be identified in a modification.
The Local Government agrees to release Federal prisoners only to LEOs of the authorized Federal
Government agency initially committing the Federal prisoner (e.g., Drug Enforcement
Administration (DEA), Immigration and Customs Enforcement (ICE)) or to a Deputy United States
Marshal (DUSM) or USMS designee with proper credentials. Those Federal prisoners who are
remanded to custody by the USMS may only be released to the USMS or an individual specified
by the USMS in the Judicial District.
USMS Federal prisoners sought for a state or local court proceeding must be acquired through a
Writ of Habeas Corpus or the Interstate Agreement on Detainers and then only with the
concurrence of the jurisdictional United States Marshal (USM).
(End of Provision)
11. Prisoner Work Program (November 2021)
Federal prisoner labor shall be used in accordance with the Federal prisoner work plan developed
by the Local Government and approved by the USMS. The Federal prisoner work plan must be
voluntary, and may include work or program assignments for industrial, maintenance, custodial,
service, or other jobs. Federal prisoners may not be required to work. Federal prisoners may
volunteer to work within the secure confines of the facility if they sign a waiver of their right not
to work. A Federal prisoner with suicidal tendencies, attempted escapes or escape history, violent
history, gang affiliations or with detainers for pending charges with other local, state, or federal
agencies will not be considered for the volunteer program. Federal prisoners are not permitted to
act as trustees and may not work in positions that permit unsupervised contact with segregated
prisoners or Federal prisoners of the opposite sex.
The Federal prisoners are restricted from operating equipment that may expose the Federal
prisoners to grave bodily harm or any work assignment requiring security risk items and controlled
tools which could be used to facilitate an escape or used as a weapon that could endanger staff,
citizens, or other inmates. Federal prisoners will not have access to prisoner or employee records.
The Local Government will ensure that prisoners who volunteer to work are prohibited from
keeping medication on their person while at the worksite, unless deemed necessary by medical
personnel.
Federal prisoners must obtain required medical clearances before working in the food service
areas. The Federal prisoner work program shall not conflict with any other requirements of the
agreement and must comply with all applicable laws and regulations. Federal prisoners shall not
be used to perform the responsibilities or duties of an employee of the Local Government.
Page 8of18
Local Government (initial): -L
Federal Government (initial): T_
Agreement Number 12-94-0006
Appropriate safety/protective clothing and equipment shall be provided to Federal prisoner
workers as appropriate. Federal prisoners shall not be assigned work that is considered hazardous
or dangerous. This includes, but is not limited to, areas or assignments requiring great heights,
extreme temperatures, use of toxic substances and unusual physical demands. Federal prisoner
workers can be paid the identical rates of pay as other facility prisoners.
Federal prisoners shall be required to participate in normal housekeeping duties which help ensure
the cleanliness of their housing area. Increases and reductions in privileges may be used as
incentives to ensure that Federal prisoners keep their living areas clean.
(End of Provision)
12. Guard/Transportation Services to/from Medical Facility (May 2021)
When Medical Facility in block # 14 on page one (1) of this agreement is checked, the Local
Government agrees, subject to the availability of its personnel, to provide transportation and guard
services for Federal prisoners housed at the Facility to and from a medical facility for outpatient
care, and transportation and stationary guard services for a maximum of twelve (12) hours per
occurrence for Federal prisoners admitted to a medical facility. The Federal Government
agrees to assumes hospital guard duty via Federal Government personnel.
These services shall be performed by at least two (2) armed and qualified LEOs or Correctional
Officers (CO) according to the criteria specified by the County Entity running the facility. In all
cases, these are part of a fulltime Law Enforcement Organization or Correctional Organization and
that they have met the minimum training requirements.
The Local Government agrees to provide additional personnel if requested by the USMS to enhance
specific requirements for security, prisoner monitoring, and contraband control. Federal prisoners
are not permitted to use the telephone, internet or WIFI enabled devices, or to receive outside
food, drinks, or deliveries (including flowers) without consent from the USMS. The Local
Government shall restrain Federal prisoners by attaching at least one extremity to the hospital
bed, stretcher, or chair at all times when medically possible. Pregnant or postpartum prisoners
should not be restrained. Postpartum is the twelve -week period following childbirth, miscarriage,
or abortion. See First Step Act provision for more information.
The reimbursable hourly rate, if agreed upon, will be shown in block #13 on page one (1) of this
agreement.
Mileage shall be reimbursed in accordance with the current GSA mileage rate.
(End of Provision)
Page 3 of 1S
Local Government (initial): 1tL
Federal Government (initial): TE
Agreement Number 12-94-0006
13. Guard/Transportation Services to/from U.S. Courthouse (May 2021)
When U.S. Courthouse in block #14 on page one (1) of this agreement is checked, the Local
Government agrees, subject to the availability of its personnel, to provide transportation and guard
services for Federal prisoners housed at its facility to and from the U.S. Courthouse. These services
shall be performed by at least two (2) armed and qualified LEDs or COs. In all cases, these are
part of a fulltime Law Enforcement Organization or Correctional Organization and that they have
met the minimum training requirements.
The Local Government agrees to provide additional personnel if requested by the USMS to enhance
specific requirements for security, prisoner monitoring, and contraband control.
Upon arrival at the courthouse, the Local Government's transportation guard will turn Federal
prisoners over to the USMS only upon presentation of proper law enforcement credentials.
The Local Government will not transport Federal prisoners to any U.S. Courthouse without a
specific request from the USMS who will provide the prisoner's name, the U.S. Courthouse, and
the date the prisoner is to be transported.
Each prisoner will be fully restrained in handcuffs, waist chain, and leg restraints during
transportation unless otherwise authorized by the USMS. Deviations from full restraints must be
documented and reported monthly to the local district USM, Chief, or their designee and to the
USMS POD at PODCoCInquiries@usdoj.aov.
The reimbursable hourly rate, if agreed upon, will be shown in block #13 on page one (1) of this
agreement.
Mileage shall be reimbursed in accordance with the current GSA mileage rate.
(End of Provision)
14. Guard/Transportation Services to Justice Prisoner & Alien Transportation System
(JPATS) or Other (May 2021)
When JPATS, Other or both in block #14 on page one (1) of this agreement is checked, the Local
Government agrees, subject to the availability of its personnel, to provide transportation and
escort guard services for Federal prisoners housed at its facility to and from the JPATS or other
locations designated by the Federal Government.
These services shall be performed by at least two (2) armed and qualified LEOs or COs. In all
cases, these are part of a fulltime Law Enforcement Organization or Correctional Organization
and that they have met the minimum training requirements.
The Local Government agrees to provide additional personnel if requested by the USMS to
enhance specific requirements for security, prisoner monitoring, and contraband control.
Page 10 of 18
Local Government (initial): III —
Federal Government (initial): T_
Agreement Number 12-94-0006
The Local Government shall not transport Federal prisoners to the airlift or any other location
without a specific request from the USMS who will provide the prisoner's name, location
(district), and the date the prisoner is to be transported.
The Local Government shall turn Federal prisoners over to the USMS or an officer specified by
the USMS only upon presentation of proper credentials.
Each prisoner will be fully restrained in handcuffs, waist chain, and leg restraints during
transportation unless otherwise authorized by the USMS. Deviations from full restraints must be
documented and reported monthly to the local district USM, Chief, or their designee and to the
USMS POD at PODCoCInquiries(dusdoj_gov.
The reimbursable hourly rate, if agreed upon, will be shown in block #13 on page one (1) of this
agreement.
Mileage shall be reimbursed in accordance with the current GSA mileage rate.
(End of Provision)
15. Video Teleconference Hearings within the Facility (October 2021)
If available, the facility shall furnish, as applicable to this agreement, all things necessary for, or
incident to, providing Video Teleconference (VTC) hearings within the facility. When VTC
equipment is not available at the facility, the Federal Government, in coordination with the Courts,
may assist with providing VTC equipment and ancillary items to the facility.
(End of Provision)
16. Optional Guard Services to Video Teleconference Hearings within Facility (May
2021)
When Video Teleconferencing (VTC) Hearings in block #14 on page one (1) of this agreement is
checked, the Local Government agrees, subject to the availability of its personnel, to provide
escort guard services for Federal prisoners housed at its facility to monitor, on a case -by -case
basis, court hearings conducted via VTC within its facility per instruction of the Federal Judiciary.
The reimbursable hourly rate, if agreed upon, will be shown in block #13 on page one (1) of this
agreement.
(End of Provision)
17. Special Notifications (May 2021)
The Local Government shall notify the Federal Government of any activity by a Federal prisoner,
which would likely result in litigation or alleged criminal activity.
The Local Government shall immediately notify the Federal Government of an escape of a Federal
prisoner. The Local Government shall use all reasonable means to apprehend the escaped Federal
prisoner and all reasonable costs in connection therewith shall be borne by the Local Government.
Page 11 of 18
Local Government (initial): `Z¢-
Federal Government (initial): TE
Agreement Number 12-94-0006
The Federal Government shall have primary responsibility and authority to direct the pursuit and
capture of such escaped Federal prisoners. Additionally, the Local Government shall notify the
Federal Government as soon as possible when a Federal prisoner is involved in an attempted
escape or conspiracy to escape from the Facility.
In the event of a medical emergency, death, or assault on or by a Federal prisoner, the Local
Government shall immediately notify the Federal Government.
(End of Provision)
18. Body Worn Camera Information Requests (November 2021)
If the Local Government adopts a Body Worn Camera (BWC) use policy that mandates use of BWC
for transport or other activities covered under the IGA, the agency shall, upon request by USMS,
provide USMS with the audio/video footage and any metadata captured by the BWC pertaining to
USMS prisoner incidents. The audio/video footage and any metadata may be requested by the
USMS Body Worn Camera Program and the USMS Office of General Counsel. The agency agrees
that no BWC footage depicting a USMS prisoner will be released without advance written
notification to the USMS.
(End of Provision)
19. Restrictive Housing and Suicide Prevention (May 2021)
For the purposes of this agreement, "restrictive housing" means any type of detention that involves
all of the following elements:
a. Removal from the general population, whether voluntary or involuntary;
b. Placement in a locked room or cell, whether alone or with another prisoner; and
c. Inability to leave the room or cell for the vast majority of the day, typically 22 hours
or more.
For the purposes of this agreement, "vulnerable population" refers to prisoners who are more
likely to be victimized in confinement settings, including but not limited to: juveniles; young
adults (age 18-24 at time of admission through conviction); prisoners with serious mental illness;
lesbian, gay, bisexual, prisoners who identify as sex nonconforming; pregnant and postpartum
prisoners; infirmed prisoners and prisoners with medical needs.
The Local Government shall have written policies, procedures, and practices requiring that all
prisoners in restrictive housing are personally observed by a CO at least twice per hour, but no
more than thirty (30) minutes apart, on an irregular schedule. Prisoners who are violent or
mentally ill or who demonstrate unusual or bizarre behavior shall receive more frequent
observation; suicidal prisoners shall be under constant observation.
The Local Government shall immediately notify the appropriate Chief Deputy U.S. Marshal
(CDUSM), or designee, and POD at PODCoCinquiries(a)usms.doLaov when a member of a
vulnerable population is placed in restrictive housing or their restrictive housing status changes.
Page 12 of 18
Local Government (initial): Q1—
Federal Government (initial): TF
Agreement Number 12-94-0006
The Local Government shall also provide reports to the USMS on a monthly basis listing all USMS
prisoners who were detained in restrictive housing, and the reasons for their assignment to
restrictive housing. When no USMS prisoners have been placed in restrictive housing during the
reporting month, the Local Government shall notify USMS that there are no USMS prisoners to
report. The report or a notification of no USMS prisoners in restrictive housing' shall be submitted
to the CDUSM or his or her designee and POD at PODCoCinguiries(C)usms.doj.clov, no later than
the tenth day of each month in a standard format established by the USMS.
The Local Government shall have a comprehensive suicide -prevention program in place
incorporating all aspects of identification, assessment, evaluation, treatment, preventive
intervention, and annual training of all medical, mental health, and correctional staff.
Additional prisoner suicide prevention resources can be found at:
https://www.usmarshals.gov/prisoner/suicide prevention.htm and https://nicic.gov/.
(End of Provision)
20. Prison Rape Elimination Act (PREA) (November 2021)
The Facility must post Prison Rape Elimination Act (PREA) brochure/bulletins in each housing unit
of the Facility. The Facility must abide by all relevant PREA regulations at:
(https://www.prearesourcecenter.org/about/prison-rape-elimination-act-Area).
All sexual harassment and sexual assaults of or by a USMS prisoner must be reported to the
district CDUSM or designee and the POD at: PREAinguiriesCa usdoj.gov.
In accordance with PREA, the Facility must arrange for a PREA audit every three (3) years. The
Facility must maintain PREA compliance or be actively working towards compliance.
Additional resources can be found at: https://www.prearesourcecenter.org/.
Templates for PREA posters and brochures can be found at:
https://www.prearesourcecenter.org/library/search?keys=poster&cat=All
(End of Provision)
21. PREA Prisoner Incident Reporting (November 2021)
PREA posters shall contain information on how to report a sexual assault by using one of the
following methods:
• Speaking with a staff member;
• Writing a letter reporting the alleged sexual misconduct to the person in charge or the
USMS. To ensure confidentiality, use special (Legal) mail procedures;
• Filing an Emergency Prisoner Grievance - If you decide your complaint is too sensitive to
file with the Officer in Charge, you can file your Grievance directly with the CDUSM. You can
get the forms from your housing unit officer, or a Facility supervisor;
Page 13 of 18
Local Government (initial): ILL
FederalGovernment (initial): TF—
Agreement Number 12-94-0006
• Writing to the Office of Inspector General (OIG), which investigates allegations of staff
misconduct. The address is: Office of Inspector General, U.S. Department of Justice, 950
Pennsylvania Ave. Room 4706, Washington, DC. 20530; or
• Calling, at no expense to the victim, the OIG. The phone number is 1-800-869-4499.
All allegations of sexual abuse reported to Facility staff must be reported and will be investigated.
Information concerning the identity of a prisoner victim reporting a sexual assault, and the facts
of the report itself, shall be limited to those who have the need to know in order to make decisions
concerning the prisoner-victim's welfare and for law enforcement investigative purposes.
(End of Provision)
22. Federal Acquisition Regulation (FAR) Agreement Provisions (May 2021)
This agreement incorporates the following agreement provisions by reference, with the same force
and effect as if it was given in full text. Upon request, the full text will be made available. The full
text of this provision may be accessed electronically at: http://www.acquisition.gov.
Agreement Provisions:
FAR 52.222-4 Contract Work Hours and Safety Standards - Overtime (May 2018)
FAR 52.222-41 Service Contract Labor Standards. (November 2024)
If the Collective Bargaining Agreement in block #15 on page one (1) of this Agreement is checked,
the Local Government agrees In accordance with Section 2 (a) and 4 (c) of the Services Contract
Act, as amended, employees employed by the contractor (s) in performing services covered by
the Collective Bargaining Agreement (s) are to be paid wage rates and fringe benefits set forth in
the current collective bargaining agreement and modified extension agreements.
FAR 52.222-42 Statement of Equivalent Rates for Federal Hires (May 2014)
FAR 52.222-43 Fair Labor Standards Act and the Service Contract Labor Standards - Price
Adjustment (Multiyear and Option Contracts) (August 2018)
The current Local Government per -diem rates shall be the prevailing wages unless notified by the
Federal Government.
If the Department of Labor Wage Determination in block #15 on page one (1) of this Agreement
is checked, the Local Government agrees, in accordance with FAR 52.222.43 (a), (f), that it must
notify the Federal Government of any increase or decrease in applicable wages and fringe benefits
claimed under this clause within thirty (30) days after receiving a new wage determination.
(End of Provision)
Page 14 of 18 ��
Local Government (initial):
Federal Government (initial): T-F
Agreement Number 12-94-0006
23. Guaranteed Minimum Bed Space (September 2021)
This IGA does not contain a guaranteed minimum for bed space.
(End of Provision)
24. Economic Rate Adjustments (October 2021)
The Federal Government will use various price analysis techniques and procedures to ensure the
rates established by this agreement is considered a fair and reasonable price. Examples of such
techniques include, but are not limited to, the following:
a. Comparison of the requested rate with the Independent Government Estimate for
detention services, otherwise known as the Core Rate;
b. Comparison with rates at other state or local facilities of similar size and economic
conditions;
c. Comparison of previously proposed prices and previous Federal Government and
commercial contract prices with current proposed prices for the same or similar
items; and
d. Evaluation of the provided jail operating expense information.
The firm -fixed price per -diem rate for services is stipulated in block #11 on page one (1) of this
agreement and shall not be subject to adjustment on the basis of Santa Ana City Jai! actual cost
experience in providing the service. The per -diem rate shall be fixed for a period from the effective
date of this agreement forward for thirty-six (36) consecutive months. The per -diem rate
covers the support of one Federal prisoner per "Federal prisoner day", which shall include the day
of arrival, but not the day of departure.
The per -diem rate and the guard/transportation hourly rate will remain unchanged during the
renewal period(s) unless the Local Government requests an economic rate adjustment. To request
a per -diem economic rate adjustment, the Local Government will need to access USMS' Capture
system via the Law Enforcement Enterprise Portal (LE EP) at
https://porta1.ciis.gov/wps/myl2ortal/LEEPNG. The Local Government may contact the
Agreements Specialist for more information.
An economic rate adjustment to either rate can be requested by the Local Government after
thirty-six (36) months of continuous performance. Request for economic rate adjustments
prior to the ending of the thirty-six (36) month period preceding the most recent rate
adjustment shall only be considered if there are extreme circumstances that warrants a review of
an out of cycle economic rate adjustment. Granting an out of cycle economic rate adjustment is
not guaranteed.
To request an out of cycle per -diem economic rate adjustment, the Local Government will need to
follow the same instructions as requesting an economic rate adjustment during the renewal period.
For the request to be considered, the Local Government must demonstrate that its costs have
substantially increased during the current thirty-six (36) month period. The Local Government
shall provide the Agreements Specialist documentation to include cost and pricing data to justify
Page 15 of 18 2�
Local Government (initial):
Federal Government (initial): TE
Agreement Number 12-94-0006
the facility's out of cycle economic rate adjustment request. The request and its supporting
documentation are the sole responsibility of the Local Government to provide a complete request
package to the Agreements Specialist. Incomplete or missing data may delay the request being
processed or causing the request to be denied altogether.
Two (2) or more out of cycle economic rate adjustment requests within the same thirty-six (36)
month period with an aggregate proposed increase of 25% or more are not permissible under
this agreement.
(End of Provision)
25. Billing and Financial Provisions (May 2021)
The Local Government shall prepare and submit for certification and payment, original and
separate invoices each month to each Federal Government component responsible for Federal
prisoners housed at the Facility.
Address(es) for the component(s) is/are:
United States Marshals Service Federal Bureau of Prisons United States Marshals Service
Central District of California Long Beach RRM Southern District of California
350 W. 1st St, Suite 3001 1299 Seaside Ave 333 West Broadway, Suite 100
Los Angeles, CA 90012 San Pedro, CA 90731 San Diego, CA 92101
(213) 894-2496 (424) 450-2866 (619) 557-6620
To constitute a proper monthly invoice, the name and address of the Facility, the name of each
Federal prisoner, their specific dates of confinement, the total days to be paid, the appropriate per
diem rate as approved in the agreement, and the total amount billed (total days multiplied by the
per -diem rate per day) shall be listed, along with the name, title, complete address, and telephone
number of the Local Government official responsible for invoice preparation. Additional services
provided, such as transportation and guard services, shall be listed separately and itemized.
Nothing contained herein shall be construed to obligate the Federal Government to any
expenditure or obligation of funds in excess of, or in advance of, appropriations in accordance with
the 31 U.S.0 Section 1341 - Limitations on expending and obligating amounts.
(End of Provision)
26. Payment Procedures (May 2021)
The Federal Government will make payments to the Local Government at the address listed in
block #6 on page one (1) of this agreement. The payments will be made promptly after the district
office has received and certified the invoice is correct.
(End of Provision)
Page 16 of 18
Local Government (initial): 12L.
Federal Government (initial): _TE-
Agreement Number 12-94-0006
27. Hold Harmless (May 2021)
It is understood and agreed that the Local Government shall fully defend, indemnify, and hold
harmless the United States of America, its officers, employees, agents, and servants, individually
and officially, for any and all liability caused by any act of any member of the Local Government
or anyone else arising out of the use, operation, or handling of any property (to include any vehicle,
equipment, and supplies) furnished to the Local Government in which legal ownership is retained
by the United States of America, and to pay all claims, damages, judgments, legal costs, adjuster
fees, and attorney fees related thereto. The Local Government will be solely responsible for all
maintenance, storage, and other expenses related to the care and responsibility for all property
furnished to the Local Government.
(End of Provision)
28. Disputes (May 2021)
Disputes, questions, or concerns pertaining to this Agreement will be resolved between appropriate
officials of each party. Both the parties agree that they will use their best efforts to resolve the
dispute in an informal fashion through consultation and communication, or other forms of non-
binding alternative dispute resolution mutually acceptable to the parties.
(End of Provision)
29. Review of Services (November 2021)
Review standards for prisoners may differ among authorized agency users. The Local Government
agrees to allow periodic unannounced reviews by Federal Government, to include approved Federal
contractors, in accordance with the standards required by any or all of the Federal authorized
agency users whose prisoners may be housed pursuant to this Agreement. A summary of
inspection findings will be shared with the facility administrator in order to promote improvements
to facility operations, conditions of confinement, and levels of services. If the Federal Government
identifies significant finding(s) during the review, the Local Government will provide the Federal
Government with a corrective action plan to address the issue(s).
(End of Provision)
30. IGA Amendments (May 2021)
For all amendments except for full or partial terminations, either party may initiate a request for
amendment to this agreement in writing. All amendments negotiated will be effective only upon
written approval of both parties.
(End of Provision)
Page 17 of 18
Local Government (initial): CIM.
Federal Government (initial): T
Agreement Number 12-94-0006
31. Litigation (May 2021)
The Federal Government shall be notified, in writing, of all litigation pertaining to this agreement
and provided copies of any pleadings filed or said litigation within five (5) business days of the
filing.
The Local Government shall cooperate with the Federal Government legal staff and the United
States Attorney regarding any requests pertaining to Federal Government or Local Government
litigation.
(End of Provision)
32. The First Step Act (May 2021)
This agreement refers the Local Government facility operations and administrations to the
following sections of the First Step Act:
a. Section 613 of Public Law 115-391 the FIRST STEP Act of 2018 and 18 USC 5043
with respect to any USMS juveniles in custody.
b. Section 301 of Public Law 115-391 the FIRST STEP Act of 2018 and that pursuant to
USMS policy that these requirements have been adopted for all pregnant and
postpartum USMS prisoners, regardless of case status. The postpartum period is
twelve weeks after childbirth, miscarriage, or abortion.
(End of Provision)
(End of Agreement)
Page 18of18
Local Government (initial): VAL.
Federal Government (initial): TF
7/24/25, 11:06 AM
SAM.gov
REGISTER OF WAGE DETERMINATION UNDER I U.S. DEPARTMENT OF LABOR
THE SERVICE CONTRACT ACT JEMPLOYMENT STANDARDS ADMINISTRATION
By direction of the Secretary WAGE AND HOUR DIVISION
of Labor WASHINGTON D.C. 20210
Wage Determination No.: CBA-2025-323
Diane Koplewski Division of Revision No.: 0
Director Wage Determinations Date Of Last Revision: 07/24/2025
1
State: California
Area: Orange
Employed on U.S. MARSHALS SERVICE contract for Employed on DEPT OF JUSTICE US MARSHALS SVC(IGA 12-94-0006) for Prisoner
Housing and Guard/Transport Services.
Collective Bargaining Agreement between contractor: The City of Santa Ana, and
union: SANTA ANA CITY EMPLOYEES, CHAPTER 1939/SERVICE EMPLOYEES INTERNATIONAL UNION LOCAL 721, PART TIME NON CIVIL SERVICE
EMPLOYEE REPRESENTATION UNIT Local , effective 11/16/2022 through 11/15/2024.
In accordance with Section 2(a) and 4(c) of the Service Contract Act, as amended,
employees employed by the contractor(s) in performing services covered by the
Collective Bargaining Agreement(s) are to be paid wage rates and fringe benefits
set forth in the current collective bargaining agreement and modified extension
agreement(s).
https://sam.gov/wage-determination/cba/agreement/75078/document 1/2
7/24/25, 11:08 AM
SAM.gov
REGISTER OF WAGE DETERMINATION UNDER I U.S. DEPARTMENT OF LABOR
THE SERVICE CONTRACT ACT JEMPLOYMENT STANDARDS ADMINISTRATION
By direction of the Secretary WAGE AND HOUR DIVISION
of Labor WASHINGTON D.C. 20210
Wage Determination No.: CBA-2025-324
Diane Koplewski Division of Revision No.: 0
Director Wage Determinations Date Of Last Revision: 07/24/2025
1
State: California
Area: Orange
Employed on U.S. MARSHALS SERVICE contract for Employed on DEPT OF JUSTICE US MARSHALS SVC(IGA 12-94-0006) for Prisoner
Housing and Guard/Transport Services.
Collective Bargaining Agreement between contractor: The City of Santa Ana, and
union: Full -Time Employees Unit Service Employees International Union Local 721 Local , effective 07/01/2022 through
06/30/2025.
In accordance with Section 2(a) and 4(c) of the Service Contract Act, as amended,
employees employed by the contractor(s) in performing services covered by the
Collective Bargaining Agreement(s) are to be paid wage rates and fringe benefits
set forth in the current collective bargaining agreement and modified extension
agreement(s).
https://sam.gov/wage-determination/cba/agreement/75077/document 112
7/24/25, 11:08 AM
SAM.gov
REGISTER OF WAGE DETERMINATION UNDER I U.S. DEPARTMENT OF LABOR
THE SERVICE CONTRACT ACT JEMPLOYMENT STANDARDS ADMINISTRATION
By direction of the Secretary WAGE AND HOUR DIVISION
of Labor I WASHINGTON D.C. 20210
Wage Determination No.: CBA-2025-325
Diane Koplewski Division of Revision No.: 0
Director Wage Determinations Date Of Last Revision: 07/24/2025
State: California
Area: Orange
Employed on U.S. MARSHALS SERVICE contract for Employed on DEPT OF JUSTICE US MARSHALS SVC(IGA 12-94-0006) for Prisoner
Housing and Guard/Transport Services.
Collective Bargaining Agreement between contractor: The City of Santa Ana, and
union: The Santa Ana Police Officers Association Local , effective 01/01/2024 through 06/30/2027.
In accordance with Section 2(a) and 4(c) of the Service Contract Act, as amended,
employees employed by the contractor(s) in performing services covered by the
Collective Bargaining Agreement(s) are to be paid wage rates and fringe benefits
set forth in the current collective bargaining agreement and modified extension
agreement(s).
https://sam.gov/wage-determination/cba/agreementt75079/document 1/2
7/24/25, 11:09 AM
SAM.gov
REGISTER OF WAGE DETERMINATION UNDER I U.S. DEPARTMENT OF LABOR
THE SERVICE CONTRACT ACT JEMPLOYMENT STANDARDS ADMINISTRATION
By direction of the Secretary WAGE AND HOUR DIVISION
of Labor WASHINGTON D.C. 20210
wage Determination No.: CBA-2025-326
Diane Koplewski Division of Revision No.: 0
Director Wage Determinations Date Of Last Revision: 07/24/2025
1
State: California
Area: Orange
Employed on U.S. MARSHALS SERVICE contract for Employed on DEPT OF JUSTICE US MARSHALS SVC(IGA 12-94-0006) for Prisoner
Housing and Guard/Transport Services.
Collective Bargaining Agreement between contractor: The City of Santa Ana, and
union: Santa Ana Police Management Association Representation Unit Local , effective 01/01/2022 through 06/30/2025.
In accordance with Section 2(a) and 4(c) of the Service Contract Act, as amended,
employees employed by the contractor(s) in performing services covered by the
Collective Bargaining Agreement(s) are to be paid wage rates and fringe benefits
set forth in the current collective bargaining agreement and modified extension
agreement(s).
https:/Isam.gov/wage-determination/cba/agreement[75080/document 112
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
U.S. Department of Justice
United States Marshals Service
FACILITY FACTS
FACILITY OVERVIEW
Name
Address
Detention Facility Review
Phone Number
Fax Number
City
State Zip Code
County
District
Contract/Agreement Number
Contract/Agreement T re
(Private, IGA, LUA) Expiration Date
Closest USMS Office Name
Driving Time from Closest USMS
Driving Distance from Closest Date of Last USMS Detention
Office
USMS Office
Facility Review_
minutes
=
miles
Points of Contact (Administrative, Facility, Intelligence, Medical, PREA, Restrictive Housing, Security)
(If needed, use "Other Notes Section" on last page to document more than one point of contact.)
Title Name
Tntact � Phone Number Exten� Email
Title Name
Type of Contact Phone Number Extension Email Address
I 11 177-11 1
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sote use of the intended reciplent(s). Any unauthorized review, use, disclosure, or distribution Is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law andfor the Privacy Act and will be
reported as such.
UNCLASSIFIEDI/LAW ENFORCEMENT SENSITIVE (When Completed)
Page 1 of 27
Form USM-218
Rev. 02126
UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed)
Title Name
Type of Contact Phone Number Extension Email Address
Title Name
Type of Contact Phone Number Extensions Email Address p -
Tilde Name
Type of Contact Phone Number . } Extension Email Address
I
Title Name
Type of Contact Phone Number Extension Email Address
Title Name
Type of Contact Phone Number Extension Email Address
x
NOTICE.. This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 2 of 27 Rev. 02125
UNCLASSIFIEDI/LAW ENFORCEMENT SENSITIVE (When Completed)
Prisoner Information (Annotate the number of prisoners per category)
Adult Male Adult Female Juvenile Male Juvenile Female Total
Total Facility Bed Capacity
LISMS Allocated Beds
Facility Average Daily
Population (Last 12 Months)
USMS, Average Daily
Population
I
L
Local/Non-Federal
Average Daily Population
Bureau of Prisons
Average Daily Population
ICE
Average Daily Population
Security Staff Information (Annotate number of authorized and filled positions per facility's staffing plan)
Authorized Filled
Warden
Assistant Warden
Chief of Security
Shift Supervisors
Other Supervisors
Corrections Officers
Transportation Officers
Perimeter Security
Restrictive Housing Security
Other Security
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document, Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law andlor the Privacy Act and will be
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 3 of 27 Rev. 02/25
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Medical Staff Information (Annotate number of authorized and filled positions per facility's staffing plan)
Authorized Filled
Physician
Physician's Assistant
Nurse Practitioner
Registered Nurse
Licensed Practical Nurse L
Mental Health Professional ---�
Other Medical Staff
Contraband
List facility's total number of contraband incidents since last USMS DFR (if applicable),
Drugs or Alcohol
I I
Electronic Device Accessory
Incidents
Drugs or Alcohol Paraphernalia
Weapon
List facility's total number of incidents since last USMS DFR (if applicable).
Suicides Suicide Attempts
Escape Attempts Physical Assaults on Prisoners
Health Care Grievances Natural Deaths
Electronic Devices
Tool
Escapes
Physical Assaults on Staff
Sexual Assaults on Prisoners
Sexual Assaults on Staff Homicides Riots/Disturbances
[Overdose Deaths Overdoses Use of Force Excessive Use of Force
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
Mich 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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Page 4 of 27
Form USM-2i8
Rev. 02/25
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Was the LISMS notified of all incidents involving USMS prisoners?
r Yes r No
Incidents Not Reported (Contraband, Suicide, Suicide Attempt, Escapes, Escapes Attempts, Physical Assaults on
Prisoners, Physical Assault on Staff, Health Care Grievances, Natural Death, Sexual Assault on Prisoners, Sexual
Assault on Staff, Homicides, Riots/Distributions, Overdoses, Use of Force). (if needed, use "Other Notes Section" on
last page to document more than one incident.)
Incident Type Use Incident tyees listed above) Incident Subty e (Leave blank Date of Incident
Incident Type Use Incident types listed above) Incident Subtype (Leave blank Date of Incident
Remarks
Incident Type Use Incident types listed above) Incident Subtype (Leave blank) Date of Incident
I I I I - - I
Remarks
Incident Type Use Incident types listed above) IncidStpe Leave blank Datnt
Incident Type Use Incident types listed above Incident Subtype (Leave blank) Date of Incident
I I I I I
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended reciplent(s). Any unauthorized review, use, disclosure, or distribution is prohibited, If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 5 of 27 Rev. 02125
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
Court Action
(If needed, use "Other Notes Section" on last age to document more than 3 actions)
Are there any court orders or pending major litigation affecting the facility?
f ' Yes C No
Case Name/Number Select Functional Area
I�_______ ❑ Admin & Mgmt ❑ Food Service
Case Name/Number
Case Name/Number
I_ _ I
❑ Health Care
❑ Security & Control
® Safety & Sanitation
❑ Service & Programs
Select Functional Area
❑ Admin & Mgmt ❑ Food Service
❑ Health Care
❑ Security & Control
❑ Safety & Sanitation
❑ Service & Programs
Select Functional Area
❑ Admin & Mgmt ❑ Food Service
❑ Health Care ❑ Safety & Sanitation
❑ Security & Control ❑ Service & Programs
ADMINISTRATION AND MANAGEMENT
Date of Court Filing
Date of Court Filing
� I
Date of Court Filing
Policy Development and Monitoring
Does the facility maintain policies and procedures that describe facility operations, maintenance and administration?
t" Yes C No
Do policies have a date documenting the last time the responsible facility manager/administrator reviewed the policy to
ensure it remains current, accurate, and relevant to the facility's operation?
(— Yes (' No
If 'Yes', Date of Last Internal Review
Policy Communication and Access
Are policies and procedures communicated to all employees?
C` Yes (' No
Does staff have 24/7 access to policies and procedures?
r Yes (' No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended recipients}. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Page 6 of 27
Form USM-218
Rev. M25
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Prisoner Property and Money
Does the facility properly inventory prisoner property?
r Yes (' No
Does the facility properly store prisoner property?
r Yes r No
Does the facility properly return prisoner property?
(' Yes (' No
Does the facility properly inventory prisoner money?
(' Yes (' No
Does the facility properly store prisoner money?
(' Yes (' No
Does the facility properly return prisoner money?
Yes No
Prisoner Release
Has the facility erroneously released ANY prisoner(s) during the review period?
(- Yes (- No
Total number of non-USMS prisoners erroneously released
Accommodations for Prisoners with Disabilities
Does the facility accept prisoners with disabilities?
(' Yes (' No
Total number of USMS prisoners erroneously released
Are adequate accommodations made available for prisoners with disabilities?
(- Yes (- No
Contingency/Emergency Plans
Does the facility have a written emergency plan in place for situations that threaten facility security? (e.g, riots, hunger
strikes, disturbances, escapes, and hostage situations.)
C Yes (- No
Does the emergency plan have a date documenting the last time the responsible facility managerladministrator
reviewed the policy to ensure it remains current, accurate, and relevant to the facility's operation?
(7 Yes C No
If 'Yes', Date of Last Emergency Plan Review
I I
NOTICE.. This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEWILAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 7 of 27 Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Is a hard copy of the emergency plan available for incorporation into the district's detention plan?
C Yes (' No
Does the facility's emergency plan include the USMS prisoners housed at the facility?
C' Yes C' No
Does the facility have a written contingency plan in place for situations involving mass prisoner relocation? (e.g.,
weather, fire, flooding, facility not habitable,)
C' Yes C No
Does the contingency plan have a date documenting the last time the responsible facility manager/administrator
reviewed the plan to ensure it remains current, accurate, and relevant to the facility's operation?
C' Yes C" No.
If 'Yes', Date of Last Contingency Plan Review
Is a hard copy of the contingency plan available for incorporation into the district's detention plan?
(- Yes (- No
Does the facility's contingency plan include the USMS prisoners housed at the facility?
f Yes C' No
Staff Background Checks
Does the facility verify identity of employees prior to hiring via Fingerprints:
C Yes C' No
Does the facility verify identity of employees prior to hiring via Social Security Number:
C' Yes r No
Does the facility verify identity of employees prior to hiring via Date of Birth:
C' Yes (- No
Does the facility verify identity of contractors prior to hiring via Fingerprints:
C Yes C' No
Does the facility verify identity of contractors prior to hiring via Social Security Number:
C Yes (- No
Does the facility verify identity of contractors prior to hiring via Date of Birth:
C' Yes C" No
Does the facility verify identity of volunteers prior to hiring via Fingerprints:
C' Yes C" No
Does the facility verify identity of volunteers prior to hiring via Social Security Number:
r Yes r No
Does the facility verify identity of volunteers prior to hiring via Date of Birth:
C' Yes C' No
Are initial background and reference checks completed for all employees prior to hiring?
C` Yes (' No
NOTICE. This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law andlor the Privacy Act and will be
reported as such.
UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 8 of 27 Rev. D2125
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Are initial background and reference checks completed for all contractors prior to hiring?
C Yes C No
Are initial background and reference checks completed for all volunteers prior to hiring?
C Yes C No
Do the background and reference checks include verification of employment history for the past five (5) years?
C Yes C No
Do the background and reference checks include verification residency for the past three (3) years?
C Yes C No
Do the background and reference checks include credit history to reveal current delinquency?
C Yes C No
Do the background and reference checks include credit history to reveal unresolved liens?
C Yes C No
Do the background and reference checks include credit history to reveal accounts in collection?
C Yes C No
Do the background and reference checks include credit history to reveal court -ordered judgments?
C Yes C No
Do the background and reference checks include criminal history to reveal felony convictions?
C Yes C No
Do the background and reference checks include criminal history to reveal disqualifying misdemeanor convictions?
C Yes C No
Do the background and reference checks include verification that there are no derogatory civil records?
(' Yes C No
Do the background and reference checks address alcohol dependency?
C Yes f' No
Do the background and reference checks address drug dependency?
C Yes C No
Does the facility conduct re -investigations of employees, contractors, and volunteers?
C Yes C- No
If so, how often?
Reportinglinvestigating Staff Misconduct
How many administrative allegations of staff misconduct were reported since the last DFR (if applicable)?
How many criminal allegations of staff misconduct were reported since the last USMS DFR (if applicable)?
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such,
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Page 9 of 27
Form USM-218
Rev. 02/25
UNCLASSIFIED!/LAW ENFORCEMENT SENSITIVE (When Completed)
How many criminal allegations of staff misconduct were reported to law enforcement since the last USMS DFR (if
applicable)?
Prisoner Anti -Discrimination
Does the facility have a prisoner anti -discrimination policy?
C Yes C No
If Yes, does the policy address prisoner:
Age?
C Yes
C No
Disability?
C Yes
C No
Equal Pay/Compensation?
C Yes
C No
Harassment?
C Yes
C No
National Origin?
C Yes
C No
Pregnancy?
C Yes
C No
Race/Color?
C Yes
C No
Religion?
C Yes
C No
Retaliation?
C Yes
C No
Sex?
C Yes
C No
Sexual Orientation?
C Yes
C No
Sexual Harassment?
C Yes
C No
Are services, programs, and activities provided to all eligible prisoners?
C Yes
C No
Prison Rape Elimination Act (PREA) Compliance
Does the facility have a PREA compliance program?
C Yes C No
Does the program address the following:
Zero tolerance toward all forms of sexual abuse and sexual harassment?
C Yes
C No
Prevention and response planning?
C Yes
C No
Prisoner training and education?
C Yes
C No
Employee training and education?
C Yes
C No
Screening for risk of sexual victimization?
C Yes
C No
Reporting and investigations?
C Yes
C No
Discipline?
C Yes
C No
Medical/ mental health care?
C Yes
C No
Auditing?
C Yes
C No
Corrective action?
C Yes
C No
State compliance?
C Yes
C No
NOTICE: This document is intended FOR OFFICIAL USE. ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended recipient($). Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Page 14 of 27
Form USM-218
Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Has the facility had an audit conducted by a DOJ certified PREA auditor within the past 3 years?
r Yes �' No
If 'No'to the previous question, has a DOJ PREA audit been scheduled?
(- Yes (' No
If Yes, what is the scheduled DOJ PREA Audit Date?
I- If 'Yes' to the previous question, is a hard copy of the PREA audit available?
(' Yes r No
If'Yes', Audit Date What was the name of the Auditor?
If an audit was conducted, how many deficiencies were noted in the last PREA audit? I I
If there were deficiencies, is there a corrective action plan in place?
(' Yes (' No
If Yes, has corrective action taken place?
(- Yes r No
Reason for not scheduling a PREA audit:
n Expense of PREA Audit
❑ Expense of constructions upgrades
❑ Expense of Technology upgrades
❑ Unaware of requirement
❑ Previous PREA audit failure
HEALTH CARE
Intake Screening
Does the facility have a designated health authority with responsibility for health care services?
(' Yes (' No
Does the facility have policy or procedures for medical, mental health, and dental health screening during intake?
(' Yes (' No
Do all prisoners undergo medical screening during the initial intake process?
C Yes (' No
If 'No', how long after intake does the medical screening occur?
months days
NOTICE: This -document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL Information
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
recipient- please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDI/LAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 11 of 27 Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Does the facility ensure TS testing during the initial intake process?
C Yes C No
If 'No', how long after intake does the TB test occur?
months FI days
Are TB test results provided to the U SMS within 14 days?
C" Yes C No
If'Nd, when were results provided?
months U days
Do all prisoners undergo mental health screening during the initial intake process?
C Yes (" No
If 'No', how long after intake does the mental health screening occur?
months days
Do all prisoners undergo dental health screening within 14-days after the initial intake process?
C Yes C No
If 'No', how long after intake does the dental health screening occur?
months days
Are all comprehensive medical screening results reviewed by a physician?
C Yes C No
If Yes, how long after intake does this occur?
months days
Is a comprehensive health appraisal for each prisoner completed within 14-days after initial intake?
C Yes f No
If 'No', how long after intake does the appraisal occur?
months = days
Are intake medical screening records maintained for every prisoner?
C Yes C No
Medical, Dental, and Mental Health
Does the facility have a medical unit staffed 24/7?
C Yes C No
Does the facility employ an on -site mental health professional?
C Yes (" No
NOTICE: This document Is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended recipiengs). Any unauthorized review, use. disclosure_ or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such,
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
Form U SM-21 S
Page 12 of 27 Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Are prisoners with mental health issues identified as part of the vulnerable population?
C' Yes r No
Are prisoners with mental health issues referred to qualified mental health professionals?
(' Yes (- No
Routine, Chronic, and Emergency Health Services
Are all prisoners made aware of the process for requesting health care services?
C' Yes No
Does the facility document receipt and disposition of health care requests by prisoners?
r Yes r No
Does the facility document all health care rendered to prisoners?
( Yes C No
Does the facility document all health care referrals?
C' Yes C No
Does the facility document all health care refused by prisoners?
(- Yes f No
Does the facility have a policy or procedures for identifying medical emergencies?
f Yes C" No
Does the facility provide access to prescription medication?
C' Yes C No
Does the facility participate in the National Manged Care Contract (NMCC) and Pharmacy Program?
r Yes C No
Does the facility have an onsite pharmacy?
C" Yes C° No
Does the facility provide a 7-day supply of prescribed medication upon transfer or release?
(Yes C` No
Does the facility document responses to prisoner health care grievances?
(- Yes (` No
When does the facility respond to health care grievances?
Days
Response to Medical, Mental and Dental Health Needs
Are all prisoners who require health care beyond the capacity of the facility transferred to a facility where such care is
available?
C Yes C No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDNLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 13 of 27 Rev. 02/25
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Are facility staff certified in CPR and basic first aid?
C Yes C No
With the exception of emergencies, does the facility submit a request to the district to request approval for outside
medical services?
C Yes C No
Does the facility immediately notify the district in the event of a USMS prisoner medical emergency?
C Yes r No
Suicide Prevention
Does the facility have a suicide prevention program?
C Yes f' No
Does the facility document staff training for prisoner suicide prevention?
C Yes C' No
Does the facility have procedures for identifying prisoners at risk for suicide?
C Yes C No
Does the facility have procedures for monitoring prisoners at risk for suicide?
C Yes C No
How often are welfare inspections conducted on suicidal prisoners?
❑ Constant Observation ❑ Every 15 mins ❑ Every 30 mins ❑ Every 45 mins
❑ More than 1 hour ❑ Never
Does the facility report suicidal gestures, remarks, tendencies, and attempts to the USMS?
C Yes C No
Does the facility provide mental health services to suicidal prisoners?
C Yes C No
Does the facility report restrictive housing of suicidal prisoners to the USMS?
C Yes C No
How many suicidal prisoners were placed in restrictive housing during the rating period?
Prisoner Death
Does the facility have procedures to respond to a prisoner's death?
C Yes C No
Does the facility immediately notify the USMS in the event of a USMS prisoner death?
(` Yes C No
Does the facility review each prisoner death?
C Yes C No
❑ Every hour
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use or the intended recipient(s). Any unauthorized review, use, disclosure. or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 14 of 27 Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Infectious Disease
Does the facility have written plan to address the management and reporting of infectious and communicable diseases?
C" Yes C' No
Does the plan include:
HIV?
Yes
C' No
Tuberculosis?
C" Yes
C' No
Hepatitis?
("' Yes
(" No
Influenza?
C` Yes
(" No
Chlamydia?
C` Yes
C' No
COVID?
C' Yes
C, No
Ebola?
C` Yes
C' No
HPV?
t"` Yes
C" No
Salmonella?
C` Yes
C` No
Scabies?
C Yes
C No
Zika?
C Yes
C No
E. coli?
C" Yes
C' No
Chicken Pox?
C Yes
C' No
Does the facility report all cases of infectious and communicable diseases to the CDC?
r Yes r No
Does the facility report all cases of infectious and communicable diseases to the LISMS?
r Yes C' No
Does the facility have an infectious and communicable disease policy or procedures to:
Identify prisoners with infectious and communicable diseases? C' Yes C No
Treat prisoners with infectious and communicable diseases? C Yes C No
Quarantine prisoners with infectious and communicable diseases? C' Yes C No
Has the facility tested communication with local and federal health authorities?
C" Yes C' No
Does the facility maintain adequate PPE for all staff in the event of a pandemic?
C' Yes C` No
Does the facility maintain adequate PPE for all prisoners in the event of a pandemic?
C' Yes C' No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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 win be
reported as such.
UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed)
Page 15 of 27
Form USM-218
Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
-lE •� :•_
Correctional Supervision
Are correctional officer posts located in, or immediately adjacent to, prisoner living areas so officers can respond
promptly to emergency situations?
i Yes ("` No
Does the facility use a minimum of 2 armed officers for prisoners transportation and hospital guarding?
(- Yes r No
Are prisoners managed and supervised 24 hours a day, 7 days a week?
(- Yes C` No
Security Features
Are weekly inspections of all security devices conducted?
(' Yes C No
Security Inspections
Do supervisory staff conduct intermittent security sweeps of all areas prisoners occupy?
C° Yes C' No
Searches and Contraband
Does the facility have procedures for searching prisoners for contraband upon arrival to the facility?
C Yes C' No
Does the facility have procedures for searching prisoners for contraband prior to transporting the prisoner?
C" Yes (- No
Does the facility have procedures for searching prisoners for contraband after prisoner visitation?
' Yes C No
Does the facility have procedures for searching prisoners for contraband after work details?
f Yes C No
Does the facility notify the USMS if a USMS prisoner is found with contraband?
(' Yes C' No
Prisoner Accountability and Supervision
Does the facility have procedures for physically counting prisoners?
C Yes C' No
If Yes, provide number of counts per day
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL Information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 16 of 27 Rev. 02/25
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Use of Force
Does the facility have procedures for use of force?
C" Yes C No
Does the facility document every use of force incident?
C" Yes C No
Does the facility notify the USMS of every use of force incident involving USMS prisoners?
r Yes C No
Does the facility investigate all use of force incidents?
C Yes r No
Non -routine Use of Restraints
Does the facility have procedures for use of restraints?
' Yes r No
Is the use of restraints on pregnant or postpartum USMS prisoners documented?
C Yes C No
Does the facility report the use of restraints on pregnant or postpartum USMS prisoners?
C Yes (' No
Number of pregnant USMS prisoners housed during the period:
Key Control
Are keys controlled and inventoried?
C Yes f ` No
Tools and Culinary Equipment Control
Are tools and culinary equipment controlled and inventoried?
(' Yes C No
How many missing items were reported during the rating period?
L��
Weapons Control
Does the facility have procedures for the control and use of firearms and less -than -lethal devices?
C Yes C No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended recipienl(s). Any unauthorized review, use. disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law andfor the Privacy Act and will be
reported as such.,
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 17 of 27 Rev. 02125
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
Prisoner Handbook and Discipline
Do prisoners have 2417 access to a prisoner rule/handbook in English?
f Yes (' No
Does the prisoner rule/handbook include facility rules and disciplinary procedures for violations?
C Yes C' No
Do prisoners have 2417 access to a prisoner rule/handbook in Spanish?
C Yes C` No
Does the prisoner rule/handbook include facility rules and disciplinary procedures for violations?
C Yes C No
Restrictive Housing
Does the facility have written procedures for restrictive housing?
C Yes C No
Does the facility have written procedures for monitoring prisoners in restrictive housing?
f Yes ' No
Does the facility immediately report restrictive housing of any USMS prisoner in the vulnerable population?
C' Yes C' No
How many USMS prisoners in the vulnerable population were placed in restrictive housing during the rating period?
Does the facility report restrictive housing of every USMS prisoner, monthly to the USMS?
C Yes C No
If Yes, how many USMS prisoners were placed in restrictive housing since the rating period?
C. I
How does the facility report restrictive housing to the USMS?
❑ Email ❑ Invoices ❑ Restrictive Housing Module
Does the facility have procedures for reintegration of a prisoner from restrictive housing into the general population?
C Yes C` No
Does the facility notify the prisoner of the reason for restrictive housing?
C` Yes ( No
Does the facility conduct a disciplinary hearing within 7 days?
C Yes C' No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained In this document is to be used
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
reported as such.
UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 18 of 27 Rev. 02125
UNCLASSIFIEDBLAW ENFORCEMENT SENSITIVE (When Completed)
Criminal Organization
(If needed, use "Other Notes Section" on last page to document more than 3 organizations.)
Does the facility collect criminal organization or security threat group information?
f Yes C No
Name of Criminal Orc anization Category Leave blank Or anization Level Leave blank OID Leave blank
l� ..� �. 1 -1 F I
Name of Criminal Organization, Category Leave blank Or anization Level Leave blank OID Leave blank
_,.T�__
Name of Criminal Organization Cat eclary Leave blank Ors ani�zat`e_a_n_Level Leave blank OID leave blank
FOOD SERVICE
Sanitation Requirements
Has the facility been inspected by an external entity within the past 12 months to ensure that the food service and
equipment meets established health, sanitation, and safety protocols?
(` Yes C° No
If 'Yes', Date of Inspection
Were any violations identified?
C Yes C No
Have those violations been corrected?
C' Yes C' No
Was the facility re -inspected to ensure the violations were corrected properly?
C Yes ( No
NOTICE, This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in thls document is to be used
only to aid in providing healthcare services to federal prisoners, Any other use is a violation of Federal HIPAA Law andfor the Privacy Act and will be
reported as such.
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Page 19 of 27
Form LISM-21a
Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Adequate and Varied Meals
Does the facility provide 3 meals per day?
(- Yes (- No
Does the facility provide a minimum of 2 hot meals per day?
(- Yes (- No
Does the facility provide meals that are nutritionally adequate and varied, as approved by a dietitian?
(' Yes (' No
Does the facility serve meals that match the approved meal menus?
(' Yes (- No
Does the facility provide special meals for prisoner religious or medical needs?
C Yes (- No
SAFETY AND SANITATION
Fire Safety
Was an annual fire safety inspection conducted by an external entity?
(- Yes r No
If 'Yes', Date of Inspection
Were any violations identified?
(- Yes (- No
Have those violations been corrected?
C Yes (- No
Was the facility re -inspected to ensure the violations were corrected properly?
C Yes C No
Control of Dangerous Materials
Does the facility have procedures for the maintenance, inventory, and storage of flammable, toxic, and caustic materials
and chemicals?
(' Yes C No
Does the facility have adequate personal protective equipment for the safe handling of chemicals?
C Yes (' No
Does the facility receive training on the safe use of each chemical?
(- Yes (' No
If yes to the above question, is the training documented?
C Yes C No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the Intended reciplent(s). Any unauthorized review, use, disclosure, or distribution is prohibited, If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document Is to be used
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
reported as such.
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 20 of 27 Rev. 02125
UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed)
Clothing, Laundry and Bedding
Are all prisoners issued at least two clean sets of temperature appropriate and properly sized clothing, to include
uniforms, socks, underwear, t-shirts, braziers, and shoes?
C Yes C No
Do prisoners have access to laundry facilities, or the ability to have their clothing items washed?
C Yes (- No
Do all prisoners receive adequate bedding, to include blanket, sheets, mattress and pillow?
C Yes C No
How often is bedding washed or exchanged? (Weekly, Every 2 weeks, Every 3 weeks, Monthly, Every other month,
Never)
❑ Weekly ❑ Every 2 Wks ® Every 3 Wks ❑ Monthly ❑ Every other month ® Never
Are exceptions to the laundry schedule made when clothes are soiled?
C Yes C No
Are exceptions to the linen schedule made when linen and mattresses are soiled?
C Yes C No
Are mattresses a minimum of 12 inches from the floor?
C Yes C No
Housing
Are single cells a minimum of 56 square feet?
C Yes C No
Are double cells a minimum of 72.5 square feet?
C Yes C No
Does the facility triple bunk or use boat beds?
C Yes C No
How many times did during the rating period?
I I
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
which is for the sole use of the intended recq'pient(s). Any unauthorized review, use. disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIED11LAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 21 of 27 Rev. 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Personal Hygiene
Are toiletries provided to indigent prisoners at no cost?
C Yes C No
Are the following available at no cost:
Soap?
C Yes
C No
If No, are all prisoner charged the same fee?
C Yes
(^ No
Toothpaste?
C Yes
C No
If No, are all prisoner charged the same fee?
C Yes
C No
Razors?
C Yes
C No
If No, are all prisoner charged the same fee?
C Yes
C No
Shampoo?
C Yes
C No
If No, are all prisoner charged the same fee?
C Yes
C No
Sanitary Napkins?
C Yes
C No
If No, are all prisoner charged the same fee?
C Yes
C No
Tampons?
C Yes
C No
If No, are all prisoner charged the same fee?
C' Yes
C No
Do all prisoners have 24-hour access to an operable toilet?
C Yes C No
Do all prisoners have 24-hour access to a washbasin with hot and cold running water?
C Yes f No
Physical Facility and Equipment
Is the facility kept clean and in good repair?
C Yes C No
Is all facility equipment in proper working order?
C Yes C No
Is there any evidence or sign of mold?
C' Yes C No
Is there any evidence or sign of insects?
C Yes C No
Is there any evidence or sign of rodents?
C Yes C No
NOTICE: This document Is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 22 of 27 Rev. 02/25
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Does the facility have adequate environmental controls to provide for indoor prisoner living conditions with air
temperatures maintained between 69 and 76 degrees?
C Yes C No
SERVICE AND PROGRAMS
Classification, Review, and Housing
Does the facility have a procedure for prisoner classification, placement, and management?
C Yes C No
Does the facility regularly review a prisoners behavior or circumstances to determine housing placement?
(° Yes C No
Are all USMS prisoners clearly identified in the facility's classification system?
C Yes C No
Copay and Fees
Are prisoners charged a fee for haircuts?
C Yes (' No
If 'Yes', are all prisoners charged the same fee?
((' Yes C No
Are prisoners charged a fee for meals?
C Yes C' No
If'Yes', are all prisoners charged the same fee?
C Yes C No
Are prisoners charged a fee for medical co -pay?
C Yes C' No
If yes, are all prisoners charged the same fee?
C Yes C No
Religious Practices
Do prisoners have the opportunity to participate in the religious practice of their faith?
C Yes C No
Volunteer Work Assignments
Does the facility allow USMS prisoners to hold a job in the facility?
C Yes C No
Does the facility ensure that un-sentenced USMS prisoners are not required to hold a job in the facility unless they
volunteer to do so?
C Yes C No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIIIENTIAL Information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners. Any other use Is a violation of Federal HIPAA Law andtor the Privacy Act and will be
reported as such.
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 23 of 27 Rev. 02125
UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed)
Does the facility pay USMS prisoners for services provided during scheduled work hours?
C Yes C No
Are USMS prisoners assigned to work outside of the secure perimeter of the facility?
C Yes C No
Does the facility document all USMS prisoner work assignments?
C Yes C No
Prisoner Grievance Program
Does the prisoner grievance protocol include at least one level of appeal?
C Yes (- No
Does the facility document responses and dispositions of prisoner grievances?
(' Yes (- No
When does the facility respond to the prisoner grievances?
Months E= Days
Juveniles
Does the facility house juveniles? If 'No', move to next section.
C Yes (' No
Does the facility have procedures for housing juveniles?
C Yes C No
Does the facility ensure the special diet, exercise, and education needs of juvenile prisoners are met?
r Yes (' No
Does the facility place prisoners under 21 who are charged as juveniles in restrictive housing?
C Yes (' No
Does the facility immediately report restrictive housing of USMS juvenile prisoners?
C Yes (- No
Does the facility ensure that voluntary and involuntary restrictive housing of prisoners under 21 who are charged as
juveniles are removed from restrictive housing every 3 hours?
(- Yes C No
Exercise and Out -of -Cell Opportunities
Does the facility provide prisoners with opportunity for exercise and out -of -cell time?
(' Yes (' No
NOTICE: This document Is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document, Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIED!/LAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-21 8
Page 24 of 27 Rev, 02125
UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed)
Telephone Access
Do prisoners have adequate access to telephones?
(' Yes (' No
Access to the Courts and Legal Materials
Do prisoners have access to the courts?
(,— Yes C No
Do prisoners have access to legal material/law library?
Yes No
Access to Legal Representation
Do the prisoners have confidential access to counsel via telephone?
Yes (' No
Do the prisoners have confidential access to counsel via written correspondence?
r Yes r No
Do the prisoners have confidential access to counsel via visitation?
C Yes r No
Visitation
Does the facility have a prisoner visitation program?
Yes C No
Does the prisoner visiting room have barriers to prevent contact visitation?
C Yes C No
Mail and Correspondence
Can Prisoners send and receive mail?
(i Yes (' No
NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
only to aid in providing healthcare services to federal prisoners, Any other use is a violation of Federal HIPAA Law andfor the Privacy Act and will be
reported as such.
UNCLASSIFIED!/LAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 25 of 27 Rev. 02125
UNCLASSIFIEDRLAW ENFORCEMENT SENSITIVE (When Completed)
CONCLUSION
Other Notes
NOTICE., This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document, Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDYLAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 26 of 27 Rev. 02125
UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed)
Additional Points of Contact
Title Name
T e of Contact... Phone Number Extension Email Address
Title Name
Type of Contact Phone Number Extension Email Address
Title Name
s of Contact Phone Number Extension Email Address
Detention Facility Review (DFR) Acknowledgment
l acknowledge that l have completed DFR training within the last 365 days and I have a current USM-222. Additional
Duty Designation, designating me as a Detention Facility Reviewer,
Deention Pacill!j Reviewer Title Date
SDUSM Title Date
CDUSM/USM - _ _ Title Date
NOTICE; This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information
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
recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used
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
reported as such.
UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed)
Form USM-218
Page 27 of 27 Rev. 02125