AKA:
Document 267-2
Filed 04/23/2008
D08:\t
Page 1 of 54
10 Number: Criminal Action Number:
prelilC
..,._-
Charge:
Suffix
I
o Costs Suspended
FINANOAL
o Pay Costs
a Pay Fine $
015% 018%
Q
Fine Suspended:
fMPRlSONMENT/PROBATION
o 1n Violation of Probation/Contempt
Effective: Be imprIsoned for LevelS Treabnent:
o Revoked
o Continued
o Modified
Beglnnlng;_~
o Discharged
_
~
5
yea rs,
month s,
days
At Level
Endlng:,
_
Eff Date:
Title/Sec:
'::J Credit
o Min. Mandatory nn1e:
for
a Tlme Served
_ _
o Suspended 1mmediately
o Susp After_ _~
o
Susp Alter 0 time served for 0 time served ror 0 time served for at Level at Level Suspended after Concurrent with:
IJ Guilty but Mentally III, to be confined at Delaware psychiatric Cent~r (Delawa~ State
o Plummer/Home Canf/Day Reporting
a Plummer/Home Conf/Day Reportrng
0 Plummer/Home Canf/Day Reporting
.....cat Level.
at
Level,~
o Susp Al'ter .
Fallowed By: Probation fer
rJ Consecutive to:
8alance at Level for
at Level
o Level 4 Sentence, Hold at: (drde one) 3 RESTITUTION
5
Hospital) until competent. Amount:
TO:
Address:
o
Determined by Presentence Memo
(ONOmONS
o Work Ref~rral
:J Pay costs, fines, restitution during
o Probationary period
o SEX O~FENDER:
0 Previously Ordered
.9
0 lASe SuperviSion/EvaluatiOn 0 One Time Fee 0 De~rmlned by Probation Community Service :"r"'"-:--T"T""-.".._ _=--__ 'Hours ~o Contact with,_'t1tu-ou..>..:ic:.""el:::'C-I,,~.;;'I~~:::L. 0 Victim a Codefendant
o Pay Costs of Supervision
fC
Driving for --.,... _ ,!-}-Subst Abuse Eva! 0 A1o;lhol Treatment a Residential Drug/Ale 0 Job Training o Outpatient Drug/Ale 0 Fully Employed 04177 DUI ProgrClm 0 Zero T erance . 0 Follow Original Conditions of Probation
~g..-No
~ental
Health :::J Obtain GED 0 Random Urinalysis
Reg Istration/Com
munlty Notification
Required. Level1~ r-.......r::::::_~
Sentence: Super Ct
RELEASE·
to provide notice and register deft.
Level 5 Sentence:
DEFERRED
Dept of Correction . CqMMITM~NT
to provide notice and register deft.
olle ProSses entered on remaining charges
olle Prosses entered on Criminal Action Number(s):
PR
$
SH $
TOTAL $
CT. REP:
COQlu
Case 1:04-cv-01350-GMS
Defendant Name: AKA:
1D Number:
Criminal Action Number:
Prefix
Suffix
Document 267-2
Filed 04/23/2008
Judge:
Page 2 of 54
008:
FINANaAL
a
Pay Costs
o Costs Suspended
0
Pay Fin~ $
015% 018%
o Fine Suspended:
IMPRISONMENT/PROBATION
o In ViolatiOn of Probation/Contempt
Effective;
o Revoked
a Continued
daYS
At Level
Q
Mod/ned
a Discharged
_
~
Beglnnlng:,
Be imprisoned for-l..years._ _
~molith$,
Title/Sec:
5
Endlng:.~
level 5 Tr~atment:
Eff Date:
o Min. Mandatory TIme:
Suspended Immediately
':l Credit for
a TIme Sel\'ed
o Plummer/Home Conf/Day Reporting
o
Susp After
~__ oti"" seNe(S2r I
0 time served for
0 time served for
y
at Level
o Susp Atter~
at Level____ q Plummer/Home Canf/Day Reporting
o Susp After
Followed By: Probation for at Level
at I.evel_ _~_ 0 Plummer/Home Conf/Day ReportIng
at Level
Bali\nce at Level for Concurrent with: at Level
SI)spended after
o Consecutive to:
:J Level 4 Sentence, Hold at;
o Guilty but Mentally III, to be confined CIt Delaware Psychiatric Center (Delaware State
3
Hospital) until competent. Amount:
(circle one)
RES1TT1JTION
Q
TO:
Address:
Determined by Presentence Mmo
CONomONS
o Pay costs, fines,
re~tution
during
o Work Referral iJ Pay Costs of Supervision a CommunitY Service: a No Contact with
-:-o Subst Abuse Eva! Q Re5identral Drug/Ale o Outpatient Drug/Ale
a TASC SuperviSion/Evaluation
Q One TIme Fee
a Determined by Probation
' ,
o Probationary period o SEX OFFENDER:
Regi5tration/Com
0 Prey/ously Ordered
H,ours
muolty NotIfication
0 Victim
- ' c_ _~ _
0 Codefendant
Required.levell-';
Sentence: Super Ct to provide notice and register deft. Le\ll!I 5 sentence: Dept of Correction to provIde notice and register deft.
COMMITMENT 't
I·
".'1
o No Driving for
0 Alcohol Treatment Q Job naining 0 Fully Employ~ Q 4177 DUl Program 0 Zero Tolerance o Follow Original Conditions of Probation
erie Prosses entered on remaining charges olle Prosses entered On Criminal Acrion Number(s):
l,j Mental Health C.l Obtain GED Q Random Urinalysis
CJ6FERREO; COMMITMENT .,,::'
PR $
$H
$
TOTAL $
~
cr.RE.P:
~ry
COa!0
Case 1:04-cv-01350-GMS
STATE OF DELAWARE
VS.
IN AND FOR NEW CASTLE COUNTY
Document 267-2 Filed 04/23/2008
Page 3 of 54
JIMMY LEWIS Alias: No Aliases DOB: SBI: 00506622 CASE NUMBER: 0305016966 CRIMINAL ACTION NUMBER: IN03-06-0l75 CARJACKING 2ND(F) IN03-06-0176 THEFT $1000 OR>(F) IN03-06-0177 RESIST ARREST(M) SENTENCE ORDER NOW THIS 11TH DAY OF FEBRUARY, 2005, IT IS THE ORDER OF THE COURT THAT:
The defendant is adjudged guilty of the offense(s) charged. The defendant is to pay the costs of prosecution and all statutory surcharges.
AS TO IN03-06-0175CARJACKING 2ND Effective May 26, 2003 as follows:
TIS the defendant is sentenced
The defendant is placed in the custody of the Department of Correction for 5 year(s) at supervision level 5 Probation is concurrent to any probation now serving.
AS TO IN03-06-0176THEFT $1000 OR> TIS
- The defendant is placed in the custody of the Department of Correction for 2 year(s) at supervision level 5 - Suspended after serving 1 year(s) **APPROVED ORDER**
1
at supervision level 5 9, 2007 10:11
November
STATE
Case 1:04-cv-01350-GMS VS.
U.k"
lJJ:U.. AWAKJ!.
Document 267-2
Filed 04/23/2008
Page 4 of 54
JIMMY LEWIS DOB: 12/25/1966 SBI: 00506622
- For 1 year(s)
supervision level 4 PLUMMER CENTER at supervision level
- Suspended after serving 6 month(s)
4 PLUMMER CENTER
- For 6 month(s)
supervision level 3
- Hold at supervision level 5 Until space is available at supervision level 4
PLUMMER CENTER
Probation is concurrent to any probation now serving.
AS TO IN03-06-0177RESIST ARREST
TIS
The defendant is placed in the custody of the Department of Correction for 1 year(s) at supervision levelS - Suspended for 1 year(s) at supervision level 2
Probation is concurrent to any probation now serving.
**APPROVED ORDER**
2
November
9, 2007 10:11
Case 1:04-cv-01350-GMS
STATE OF DELAWARE
VS.
.:>r.l:.t'-.J...t"1..LJ
Document 267-2
'-V...,.., .............. _ ....
Filed 04/23/2008
.
_
Page 5 of 54
JIMMY LEWIS DOB: 12/25/1966 SBI: 00506622 CASE NUMBER: 0305016966
The defendant shall pay any monetary assessments ordered during the period of probation pursuant to a schedule of payments which the probation officer will establish. Have no contact with Patrick Geer Defendant shall successfully complete anger management, counseling, treatment program. The defendant shall undergo mental health evaluation and follow recommendation for counseling and treatment.
NOTES Aggravating Circumstances - 2 or more violent felonies Lack of Remorse
JUDGE PEGGY L ABLEMAN
**APPROVED ORDER**
3
November
9, 2007 10:11
Case 1:04-cv-01350-GMS
STATE OF DELAWARE
VS. JIMMY LEWIS DOB: 12/25/1966 SBI: 00506622
Document 267-2
Filed 04/23/2008
Page 6 of 54
CASE NUMBER: 0305016966 AGGRAVATING LACK OF REMORSE
**APPROVED ORDER**
5
November
9, 2007 10:11
Case 1:04-cv-01350-GMS
STATE OF DELAWARE
VS.
Document 267-2
Filed 04/23/2008
Page 7 of 54
JIMMY LEWIS DOB: 12/25/1966 SBI: 00506622 CASE NUMBER: 0305016966
SENTENCE CONTINUED: TOTAL DRUG DIVERSION FEE ORDERED TOTAL CIVIL PENALTY ORDERED TOTAL DRUG REHAB. TREAT. ED. ORDERED TOTAL EXTRADITION ORDERED TOTAL FINE AMOUNT ORDERED FORENSIC FINE ORDERED RESTITUTION ORDERED SHERIFF, NCCO ORDERED SHERIFF, KENT ORDERED SHERIFF, SUSSEX ORDERED PUBLIC DEF, FEE ORDERED PROSECUTION FEE ORDERED VICTIM'S COM ORDERED VIDEOPHONE FEE ORDERED
3.00 50.00 100.00
TOTAL
153.00
**APPROVED ORDER**
4
November
9,
2007 10:11
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Lf S.
Page 8 of 54
'I! !
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00044
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 9 of 54
Date: 02/22/2008
DCC Delaware Correctional Center Smyrna Landing Road
SMYRNA DE, 19977
Phone No. 302-653-9261
GRIEVANCE REPORT
OFFENDER G-RIEVANCE INFORMAY-ION Offender Name: LEWIS, JIMMY Grievance # Status : 151666 : Unresolved Grievance Type: Health Issue (Medical) IGC : Dutton, Matthew S81# Grievance Date Incident Date
_____ .._. . 0_ ._ ..
-" Institution Category Resol. Date Incident Time: : DCC
:
00506622
: 02/08/2008 : 02/08/2008
,.
Individual
Resolution Status:
Housing Location: Bldg 17, Lower, Tier A, Cell H, Single OFFENDER GRIEVANCE DETAILS
Description of Complaint:
Inmate Claims: On Feb 1, 2008 I wrote and submitted a medical sick call request form stating that my feet and severely dry and cracked and that I also have fungus in between my toes. I requested to be checked by the doctor in orlier to have the ointment Eucern and to re-prescribed to me. But the sick call slip was returned to me, stating that I should purchase said item from commissary. To be checked by the doctor in order to be prescribed the ointments I need to remedy the aforementioned condition of my feet.
------
Remedy Requested
.. -... _ - - -
---- - - - - - - - - - - - -
INDIVIDUALS INVOLVED
- ---------------
- - - - _ . ' - - - - - - _ .. -
Type
S81#
Name
------------
ADDITIONAL GRIEVANCE INFORMATION Medical Grievance: YES Investigation Sent : 02/22/2008 Grievance Amount: Date Received by Medical Unit: 02/22/2008 Investigation Sent To
Moore, Ronnie
Page 1 of 3
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 10 of 54
DELAWARE DEPARTMENT Olt CORRECTIONS
REQUEST FOR MEDICAL/DENTAL SICK CALL SERVICES
FACILITY: DELAWA ~ CTIONAL CENTER
This request is for (circle one):
EDICAL ENTAL IVIENTAL HEALTH
-:Ll ttl ffiL~~1f'J l~ _._
Na
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Dat
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Hj'Vj'O SUb~
.
s:
.'
,,,- __f,,,,,
------ ------------._._-----------------..__. Resp: ._.__ __ BIp: WT: 0: Temp:___ Pulse: --"----'----,._---,,
------
' - - ------...._-----
. _ - - - - ._--_._----.._-----------_._-
P:
._-----_._--.._ - - - - - _ . -._------------------------_.--_._----
.3/1199 UEOl
FORM/; :
MED
263
Case 1:04-cv-01350-GMS
Document 267-2 SMYRNA ut:, -1:1::1"
Phone No. 302·653·9261
Filed 04/23/2008
Page 11 of 54
INFORMAL RESOLUTION
mender Name: LEWIS, JIMMY ;rievance #
S81#
00506622
Institution
: DCC
: 21065
>tatus : Resolved 3rievance Type: Mail IGC : Merson, Lise M
Grievance Date : 11/21/2005 Resolution Status: Level 3 Incident Date : 11/21/2005
, , ",.
~1
Category : Individual Inmate Status: Incident Time:
,
Housing Location :Bldg 23, Upper, Tier D, Cell 2, Bottom
~~,i
Investigator Name
: Smith,
Tanya
Date of Report 12/09/2005
Investigation Report : Reason for Referring:
Investigator Name
: Smith, Tonya
Date of Report 04/28/2006
Investigation Report : Reason for Referring: Ms. Smith, This grievance has reached the '150 warning. Please have someone meet with the inmate for a level 1 and resolve if possible. Thank You, C I. Merson Investigator Name : Smith,
Tanya
Date of Report 08/09/2006
Investigation Report: The DCC Mail Room isto process outgoing legal mail within 48 hours of their receipt of such mail.
Reason for Referring: Ms Smith this grievance is 9 months old and there has never been an investigation done one needs . to be completed ASAP in order for a hearing to be held thank you Cpl Merson Investigator Name : Profaci, Alisa Date of Report 08/18/2006
Investigation Report : Reason for Referring: Please review with Inmate.
Investigator Name
: Burris, Betty
Date of Report 10/26/2006
Investigation Report : Reason for Referring: As per your instructions.
Investigator Name
: Smith, Tonya
Date of Report 11/30/2006
Investigation Report : Reason for Referring: fyaction.
Page 2 of 8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 12 of 54
GRIEVANCE REPORT
Offender Name :LEWIS, JIMMY Grievance # 581#
00506622
Institution Category Resor. Date
: DCC
: Individual
: 03/27/2007
: 21065
Status : Resolved Grievance Type: Mail IGC : Merson, Lise M
Grievance Date 11/21/2005 Resolution Status: Level 3
Incident Date : 11/21/2005 Incident Time:
Housing Location: Bldg 23, Upper, Tier 0, Cell 2. Bottom
Description of Complaint: The Mail Room is holding my legal mail that I am sending to the courts for 2 weeks before it is sent out. The dilemma is that the courts often order a rapid response (within 10 days) of receiving said order to respond. The 2 week delay for my response(s) can ultimately result in my case(s) being denied or procedurally barred due to my failure to respond with said court order. Remedy Requested I want my legal mail to be sent out to their destinations within 24 hours of being delivered to the Mail Room.
Medical Grievance: NO Investigation Sent : Grievance Amount:
Date Received by Medical Unit: Investigation Sent To : Smith, Tanya
Page 1 of8
Case 1:04-cv-01350-GMS
Document 267-2
Phone No. 302·653·9261
Filed 04/23/2008
Page 13 of 54
_!_-------------------~-----------------------,
GRIEVANCE INFORMATION - Appeal
Offender Name: LEWIS, JIMMY Grievance # ; 21065 5tatus : Resolved Grievance Type: Mail
IGC : Merson, Lise M
581# 00506622
Grievance Date : 11/21/2005
Resolution Status :Level 3
Appeal returned 27 March 2007. Inmate states: As an inmate prisoner, I am allowed to utilize the pay to form #34 to cover the cost for legal mail postage; for which I must do without first knowing how much the cost of the legal mail postage will be, or exactly when the legal mail actually klaves this facility. My inmate individual account statement shows withdrawls for pay to's submitted two and three months prior, nor am I able to identify exactly who is responsible for withdrawing funds from my account. Also, I need to be able to factualy varify that I have meel deadlines imposed by the courts.
Page 6 of8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 14 of 54
-.--'~--------------------'---~--------------
GRIEVANCE INFORMATION· WARDEN
.~
Offender Name: LEWIS, JIMMY Grievance # :21065 Status ; Resolved Grievance Type: Mail IGC : Merson, Lise M Due Date: Type of Information Requested: Referred to:
S81# : 00506622 Grievance Date : 11/21/2005 Resolution Status: Level 3 Incident Date : 11/21/2005
Institution : DCC Category : Individual Inmate Status: Incident Time:
Housing Location: Bid 23, Up er, Tier D, Cell 2, Bottom .. " .. . Name:
Date ReceIved Decision Date Comments
: 01/05/2007 : 03/16/2007
Vote: Deny : Denied. All outgoing legal mail is processed within 48 hours of the Mail Room receiving such. cc IGC
Inmate
WARDEN I WARDEN'S DESIGNEE SIGNATURE I WISH TO APPEAL THIS TO THE BUREAU GRIEVANCE OFFICER (B.G.O.) YES:,
DATE _ NO: _
GRIEVANT'S SIGNATURE
DATE
I.G.C. SIGNATURE'
'DATE
Page 5 c,f 8
Case 1:04-cv-01350-GMS
Document 267-2 pnone I'll,) ... u£.-u.... ·w_ _ ·
Filed 04/23/2008
Page 15 of 54
-'-------G-O-:R--:,-:O-:EV~A~N-:c-C--::OE--:,-:-::N-FO-R-M-A-T-,O-N-·R=--G,--C---------.,
--.~,
Offender Name: LEWIS, JIMMY Grievance # : 21065 Status : Resolved Grievance Type: Mail IGC : Merson, lise M Date Received: 12/26/2006
SBI#
00506622
Institution
: DCC
Grievance Date : 11/21/2005 ResolutlonStatus : Level 3 Incident Date : 11/21/2005
Category : Individual Inmate Status: Incident Time:
Housing location: Bldg 23, Upper. TierD, Cell 2, Bottom
.
~-'
\
Date of Recommendation: 01/05/2007
Hearing held 3 January 2007.
Uphold: Sent out 9-23-06. Arrived 10-5-06. Still happening. Mail addressed to Supreme court, Dover, Delaware. Court letter
states appeal was 4 days late. There is no proof 11m sent letter on 9-23-06. 11m did not address grievance dated 11-2005. -11m
stated 48 hrs deadline was acceptable. 11m would not sign.
Page
4 of 8
Case 1:04-cv-01350-GMS
Document__, . __ ._ 267-2
~I"""',.",,
Filed 04/23/2008
Page 16 of 54
Phone No. 302-653-9261
Offender Name: LEWIS, JIMMY Grievance #
sel#
Grievance Date
: 00506622
: 07/31/2005
Institution Category
: DCC : Individual
: 16149
Status : Unresolved Grievance Type: Law Library IGC : Merson, Lise M
Reso!. Date Resolution Status: Incident Date : 07/31/2005 Incident Time: Housing Location: Bldg 19, Upper, Tier Dr Cell 12, Single
Description of Complaint: Inmate claims he has bee requesting legal assistance from the LL for the last two weeks but to no avail. He states none of his correspondences are acknowledged. .
..
Remedy Requested
: Inmate requests to be told why he is being denied LL access.
Medical Grievance: NO Investigation Sent : Grievance Amount:
Date Received by Medical Unit: Investigation Sent To Little, Michael
Page'1 of 2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 17 of 54
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 18 of 54
·
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Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 19 of 54
MEMO
TO: VM Jimmy Lewis, #506622, 19-A-U7, SHU .~ FROM: Mackinnon Yo~ni,.:st'ilJ Law Library Paralegal RE: Request Received on September 8, 2005 Your request for photocopies of the attached Grievance Reports are denied on the basis that they are not legal photocopies as presented. I also refer you to Paralegal Brian Engrem's memo, dated April 19, 2005, denying a previous photocopy request of this nature.
Cc: File
Case 1:04-cv-01350-GMS
Document 267-2
FORM #584
Filed 04/23/2008
Page 20 of 54
GRIEVANCE FORM
TIME OF INCIDENT:.
_
..
ACTION REQUESTED BY GRIEVANT:
1JJl/R$:17.G~...;;...
FtJ It- rIll r
~d?:
70
t$e
_
DAlE:
WAS AN INFORMAL RESOLUTION ACCEPTED?
~(YES)
_(NO)
.
(COMPLEtE ONLY IF RESOLVED PRIOR TO HEARING)
GRIEVANt's SIGNATIJRE: .
---------
I:>ATE:.
_
IF UNRESOLYED, YOU ARE ENTITLED TO AHEARING BY THE RESIDENT GRIEVANCE COMMITrEE.
ce: iNSTITUTION FILE GRIEVANT April '97 REV
RECEIVED
JAN ;"1.72007
'nmate Grievance Office
Case 1:04-cv-01350-GMS
Document 267-2
FORM #584
Filed 04/23/2008
Page 21 of 54
GRIEVANCE FORM
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GRIEVANT'S NAME:.. CASE#:
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BRIEFLY STATE THE REASON FOR THIS GRIEVANCE. GIVE DATES AND NAMES OF OTHERS INVOLVED IN THE INCIDENT OR ANY WITNESSES.
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Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 22 of 54
MEMO TO: VM Jimmie Lewj$.#i06622 FROM: Brian Engrein, SHU Law Library Paralegal DATE: January 27,2006 RE: Photocopy Request Your photocopy request for the 21 copies is denied. You have not sent a complaint that lists all defendants. There is no reason to supply you with the same amount of cover sheets for this complaint. You will need to supply the appropriate information to proceed with this photocopy request.
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Cc: File
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 23 of 54
MEMO TO: 11M Jimmie Lewis #506622 FROM: Brian En~eITl,SHU Law Library Paralegal DATE: June 8, 2005 RE: Photocopy Request Your photocopy request is denied for photocopies. First, court cases, statutes, rules, digest keys and newspaper articles can be cited in your brief. Second, I contacted the Delaware Supreme Court regarding your case. You stated that the court rejected your brief and returned it with a citizen's guide. The court has indicated your motions have been forwarded to your lawyer John Edinger of the Public Defender's Office
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Cc: File
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 24 of 54
MEMO TO: VM Jimmy Lewis FROM: Brian En .622
~ Law Library Paralegal
DATE: April 19, 2005 RE: Request Received on April 18, 2005 If you are requesting photocopies of the attached Grievance Reports, the request is denied. These reports are not considered legal photocopies as presented.
Cc: File
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 25 of 54
MEMO TO: 11M Jimmie~ 6622 Lwi FROM: Brian En em, SHU Law Library Paralegal DATE: October 4, 2005 RE: Photocopy Request I called the US District Court in Wilmington regarding your amended complaint. The clerk's office indicates you have to be granted permission to amend your complaint. Your request for amending the complaint was received back in July. If the court grants your amended complaint, return your photocopy request with the order granting the amended complaint.
~
Cc: File
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 26 of 54
MEMO TO: VM Jimmie
Lewi~#W6622
(ftV
FROM: Brian Engrem, SHU Law Library Paralegal DATE: December 6, 2005 RE: Photocopy Request Your request is a court case sent to you from the public defender's office. The law library does not photocopy Court cases. Your request is denied. Indigent supplies are only given out by the law library when the inmate provides a documented court deadline and it is past the commissary date.
Cc: File
Case 1:04-cv-01350-GMS
JOSEPH R. BIDEN, 11\
Attorney General
Document 267-2
Filed 04/23/2008
Page 27 of 54
DEPARTMENT OF JUSTICE
NEW CASTLE COUNTY Carvel State Building 820 N. French Street Wilmington, DE 19801 Criminal Division (302) 577 8500 Fax: (302) 577-2496 Civil Division (302) 577-8400 Fax: (302) 577 -6630 TTY: (302) 577-5783 PLEASE REPLY TO:
KENT COUNTY 102 West Water Street Dover, DE 19904 Criminal Division (302) 739-4211 Fax: (302)739-6727 Civil Division (302) 739-7641 Fax: (302) 739-7652 TTY: (302) 739-1545
SUSSEX COUNTY 114 E. Market Street Georgetown, DE 19947 (302) 856-5353 Fax: (302) 856-5369 TTY: (302) 856-2500
[New Castle County-Civil Division]
May 11,2007
The Honorable Gregory M. Sleet United States District Court District of Delaware J. Caleb Boggs Federal Building 844 N. King Street Wilmington, DE 19801
Re:
Lewis v. Carroll, et al., D. Del., CA. No. 06-778-GMS
Dear Judge Sleet: Please allow this letter to reflect State Defendant Thomas Carroll's response in opposition to Plaintiff's Motion for Order to Compel Defendant Thomas L. Carrol [sic] to Place Jimmie Lewis into Protective Custody (the "Motion for Preliminary Injunction") (D.I. 10). On April 20, 2007, Inmate Jimmie Lewis, SBI #506622, asked the officers at the Delaware Correctional Center to place him in protective custody. (Exhibit A at ~ 2). Mr. Lewis's request for protective custody was based on his belief that two inmates were threatening him while he was housed on the Special Needs Unit. (Exhibit A at ~ 2; Exhibit B). Mr. Lewis was placed in protective custody the same day as his request and he remained there until May 4, 2007, when he was transferred to the Infirmary. (Exhibit A at ~ 3; Exhibit C). Mr. Lewis is, at present, still housed in the Infirmary but he will be transferred back to protective custody after the medical staff in the Infirmary discharges him. (Exhibit A at ~ 3).
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 28 of 54
The Honorable Gregory M. Sleet May 11,2007 Page 2 Mr. Lewis's classification in protective custody is reviewed on a weekly basis. (Exhibit A at ~ 4). However, Mr. Lewis will remain in protective custody until he no longer believes it necessary and signs off on a statement to that effect. (Id.). Because Mr. Lewis is housed in protective custody and will remain there until he no longer believes the inmates are threatening his life, State Defendant Carroll asks that Lewis's Motion for Preliminary Injunction be denied as moot. If the Court has any questions or concerns, or believes that a more formal response from State Defendant Carroll is required, please contact the undersigned counsel at (302) 577-8400. Thank you.
Sincerely,
/5/ Erika Y Tross
Erika Y. Tross Deputy Attorney General Attorney for State Defendant Thomas Carroll
cc: ) Jimmie Lewis, Plaintiff Enclosures
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 29 of 54
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
JIMMIE LEWIS, Plaintiff,
v.
THOMAS L. CARROLL, et al. Defendants.
) ) ) ) ) ) ) ) ) ) )
Civil Action No. 06-778-GMS Jury Trial Requested
AFFIDAVIT OF THOMAS SEACORD
I, Thomas Seacord, having been duly sworn by law, do hereby depose and state as follows: 1. I am employed by the State of Delaware Department of Correction
("DOC") as a Lieutenant in the Classification Office at the Delaware Correctional Center ("DCC"), Smyrna, Delaware. 1 have been employed by DCC since May 30, 1989 and have worked in the Classification Office since August 1, 2005. 2. On April 20, 2007, Inmate Jimmie Lewis, SBI #506622, requested
that he be moved to protective custody. Inmate Lewis stated that the reason he was requesting protective custody was because two inmates were threatening him while he was housed on the Special Needs Unit. Inmate Lewis was transferred to protective
custody - Building 18, TierC, Cell 12 - that same day. 3. Approximately two weeks later, on May 4, 2007, Inmate Lewis
was transferred to the Infirmary at DCC for treatment. Inmate Lewis is, at present, still
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 30 of 54
housed in the Infinnary. He will be transferred back to protective custody when he is discharged from the Infirmary. 4. When Lewis returns to protective custody I, along with another
counselor, will review his classification on a weekly basis. Inmate Lewis, however, will remain in protective custody until he requests removal by signing off on a statement that he no longer believes protective custody.is necessary.
-%NY:£~~ Thomas Seacord
SWORN AND SUBSCRIBED before me this 10th day of May, 2007.
Notary
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Case 1:04-cv-01350-GMS
Document 267-2 Custody
Prl?tective Filed 04/23/2008
Page 31 of 54
"
28lLewis, Jimmy
50662211NF 4/20/2007ICarjaCking 2nd,
Theft over $1000
".1
5/8/2007
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 32 of 54
IN THE SUPERIOR COURT OF THE STATE OF DELAWARE IN AND FOR NEW CASTLE COUNTY
STATE OF DELAWARE
v.
Jimmie Lewis ORDER
10: 0305016966
~ dayof j.L(~ ,2007, upon consideration of defendant's This motion for reduction/modification of sentence, the presentence report/prior record, and the sentence imposed upon the defendant;
4
NOW, THEREFORE, IT IS ORDERED that defendant's reduction/modification of sentence is DENIED for the following reason(s):
motion
for
o The sentence in this case was imposed pursuant to a Plea Agreement between the State and the defendant and signed by the defendant. Superior Court Criminal Rule 11 (e)(1 )(c).
-XThe motion was filed more than 90 days after imposition of the sentence and
is, therefore, time-barred. The Court does not find the existence of any extraordinary circumstances. Pursuant to Superior Court Criminal Rule 35(b), the court will not consider repetitive requests for reduction or modification of sentence. o The sentence imposed is mandatory and cannot be reduced or suspended. o The sentence was imposed after a violation-of-probation hearing was held, and the Court determined the defendant had violated the terms of his probation. The defendant is not amenable to probation at this time.
X The sentence is appropriate for all has been provided to the Court which the reasons stated at the time of sentencing. No additional information
would warrant a reduction or modification of this sentence.
oc: pc:
Prothonotary Defendant Department of Justice Investigative Services
Case 1:04-cv-01350-GMS
Document3D2-653-9;lti1Filed 04/23/2008 Phone No. 267-2
Page 33 of 54
GRIEVANCE REPORT
Offender Name: LEWIS, JIMMY Grievance # : 20618 Status : Unresolved Grievance Type: Staff Issues IGC : Merson, Lise M 581# : 00506622 Grievance Date : 11/1212005 Resolution Status: Incident Date : 11/1212005 Housing Location: Bldg 19, Upper, Institution : Dec Category· : Individual Resol. Date Incident Time: 10:45 Tier A, Cell 7, Single
DescriptIon of Complaint: I was sprayed with capstun by Sgt. G. Everett while secured in Building 19, AU 7 because of my . numerous request to speak to a LIeutenant. As a result I was transferred to the Infirmary for physical and psychiatric treatment. Today, Sgt. Everett approached my cell and made mention of making things worse by threatening to spray me again with capstun. She fabricated an allegation that I assaulted her. . Remedy Requested An Investigation by Internal Affairs to ensure that my U.S.C.A are unjustifiably violated.
Medical Grievance: NO Investigation Sent : Grievance Amount:
Date Received by Medical Unit: Investigation Sent To : Taylor, Ramon
Page 1 of 2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 34 Page 1 0[2 of 54
Donahue Justine (Courts)
From: Sent: To: Cc: Wright Cindy (DOC) Tuesday, March 18. 2008 10:32 AM Ableman Peggy L (Courts) Donahue Justine (Courts); Ruebeck Janice (Courts)
Subject: RE: Habeas - Jimmie Lewis 881#00506622
Your honor, Jimmy Lewis SRI: 506622 is currently serving the following sentences: #0305016966 - CR# IN03-06-0175 - Carjacking 2nd - 5 years at levelS - Sentenced on 2/11/05 by your honor. #0305016966 - CR# IN03-06-0176 - Theft $1000 or> - 2 years suspended after serving 1 year at levelS followed by 6 months at Plummer Center - followed by 6 mths at level 3. He is serving a total of 5 years at levelS. His effective date is 5/26/03 and his maximum expiration date is 5/24/09. His current short time release date after deduction of 204 statutory goodtime is 11/01/08. This inmate was housed at Delaware Psychiatric Center from 8/27/07 until 12/14/07. He was then transferred to our institution due to his violence towards DPC staff. Please do not hesitate to contact me for further information.
3/18/2008
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 35 Page 2 of2 of 54
Cindy Wright Records Supervisor Delaware Correctional Center Phone 302-653-9261 ext. 2169 Fax 302-653-5023
From: Ruebeck Janice (Courts)
Sent: Tuesday, March 18, 20089:50 AM
To: Wright Cindy (DOC)
Cc: Ableman Peggy L (Courts); Donahue Justine (Courts); Waters Ophelia (DOJ)
Subject: Habeas - Jimmie Lewis 581#00506622
This defendant has filed a Petition for Writ of Habeas Corpus. Please identify for the court all commitments on which this defendant is being held. Please provide in your response Case ID Numbers, Criminal Action Numbers, and amounts and types of bail if applicable, sentences being served, detainers, capiases and warrants, i.e. whatever is holding the defendant. If this defendant is being held awaiting Extradition, please provide the court with the time and date of the Extradition Hearing. Please respond directly to Judge Ableman to whom this Habeas Corpus petition has been assigned, with a copy to her secretary Justine Donahue and myself. A quick response may eliminate the need to have the defendant transported to the courthouse for a hearing. Thank you for your time and attention to this matter.
Janice C1(ue6eck,
Case Processing Supervisor I\lCC Prothonotary's Office ph. 302.255.0701 fx. 302.255.2265
3/18/2008
Case 1:04-cv-01350-GMS
,c=----_-'"
Document 267-2
Filed 04/23/2008
Page 36 of 54
STATE OF DELAWARE DEPARTMENT OF CORRECTION DELAWARE CORRECTIONAL CENTER
OFFICE OF THE DEPUTY WARDEN
I 18 1 Paddock Road SMYRNA, DELAWARE 19977 Telephone: (302) 653-9261 Fax: (302) 659-6667
MEMORANDUM
TO: FROM: DATE:
lnmatlf~~SBl No. C:050.,&, A::I
Deputy Warden Burris ~ March 13,2007 Inmate Letter(s)
,Housing Unit .
11>
RE:
During 2006, I did not have an opportunity to answer every inmate letter. However, action was taken on most letters received. If you wrote to me in 2006, and the topic about which you wrote is still an issue for you, please write back to me now. I am at a point where I am answering every inmate letter again; therefore, you will receive an answer in the near future.
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Case 1:04-cv-01350-GMS
NAME UNIT'
Document 267-2
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ATTENDING PSYCHIATRIST
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In the space below, please write your complaint or grievance. (Use additional pages if necessary) If you need help in completing this form - Unit Staff. the Patient Advocate (255-2775), or the Director of Consumer Affairs (255-9421) will assist you Give the completed form to unit staff or a member of your Treatment Team
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE
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Make a copy of lhis Signed/dated GrievanCE Form (or 1r,e pdllenl or family. fCax 3 copy of 1he 101Tl' to 1he Performa~lce ~ Imp~ovemen\ Dept (255-441 B) IMMEDIATEL Y, pr or 10 the sl;Jrj 01 :he Investigation.
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Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 38 of 54
Patient: Jimmie Lewis Date of Grievance: 9-8-07 Response to Patient or Patient's Representative
The name of the hospital contact person:
~
Nancy D.
Pearsall~~~~_~~~_~~_
The steps taken on behalf of the patient to investigate the grievance: Met with Mr Lewis The results of the grievance process: We can use the gold or the blue since we have two concerns, however, we will change to blue to signify that we are paying attention to aggression and also monitoring for suicide. Also on 9-11-07 you will start receiving one on one counseling from your Psychiatric social worker Mr Benjamin. The date the investigation was
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
If the resolution ~ accepted, make a copy of thiS signed/dated Gnevance Form for the patient or family Forward the original Gnevance Form to the Performance Improvement Depal1ment If the resolution IS not accepted, provide a copy of the form to the patient or patient's representative, fax a copy of the Gnevance Form to the Performance Improvement Dept (255~ 4418) and forward the original Grievance Form to the Hospital Director/Designee
HOSPITAL DIRECTOR/DESIGNEE'S RESPONSE:
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PatienURepresentative'sSignature
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
Make a copy of thiS signed/dated Grievance Form for the patient or patient's representative Performance Improvement Dept Forward the original form to the
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 39 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAME: UNIT:
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DATE:
In the space bel~w, please ~rite ~our compla~nt or grievanc~. (Use additional pages if necessary.) If you need help In completing this form - Unrt Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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DIRECTIONS FOR UNIT DI
CTORIDESIGNEE:
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Make a copy of this signed/dated Grievance Form for the patient or family Fax a copy of the form to the Performance Improvement Dept (255~4418) IMMEDIATELY, prior to the start of the investigation
8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 40 of 54
DELAWARE PSYCHIATRIC CENTER Grievance Form
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In the space below, please write your complaint or grievance: (Use additional pages if necessary.) If you need help In completing this form .- Unit Staff, the Patient Advocate (255·2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Troatment Team.
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
Make a copy of this signed/dated Grievance Forrn for the patient or family Fax a copy of the form to the Performance Improvement Dept. (255-4418) IMMEDIATELY, prior to the start ofthe in....estigatlon.
I
I
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 41 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAME:
UNIT:
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ATIENDING PSYCHIATRiSt:
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In the space below, please write your complaint or grlevance.~ (Use additional pages if necessary.) If you need help In completing this form - Unit Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or 3 member of your Treatment Team,
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DIRECTIONS FOR UNll DIRECTORJOESIGNEE:
I ImprovementDept. (255-4418) IMMEDIATEL Y, prior to the start of the invesligatlon,
Make a copy of this sighedfdaled Grievance Form for the patient or family Fax a copy of the form to the Performance
2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 42 of 54
Mr$ Lewis One to One Observation GuideHnese
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Specific Risk Issue line of the Flow sheet should read: High Risk for aggression towards other with thoughts to bang himself. Patient also noted with inappropriate sexual behavior and statements. Patients room and person is searched each shift patient and documented in the chart. Patient is not pennitted personal belonging only Bible, two set of Reds, (5) sets of underwear. Cosmetic stored in the closet and given small amount as needed. Also No razors Patient is not permitted privacy. Gender appropriate staff when using the bathroom and during pat down searches while in camera view. Staff member must be within one arm length at all times direct eye sight except when in bed room he remains eye sight and staff must be positioned in the hall way with direct eye sight an only male staff on the 11-7 shift. He must move behind any unit movements i.e. last to enter dining room and last to leave. Keep buffer between him and other patients. If patient approaches a peer or staff member in an aggressive manner this could be verbal or physical, get your peers involved immediately and call the nurse. In the event that Mr. Lewis begins to threaten or intimidate you while monitoring him notify the nurse immediately so that he can be assessed for his level of aggression towards others. Ifhe continues to threaten, intimidate, curse, posture and is unwilling to regain control after the least restrictive intervention have been attempted the nurse must consider the higher levels of interventions such as involuntary administration of medication, seclusion and Four Point Restraints ifhe has fails to deescalate while he is being secluded. The hourly summary documentation on the .flow sheet must reflect and all threatening statements as well as any behaVIOr while on the One to One observation. If you are relieved for any period the time must be reflected in the summary note. If Mr. Lewis is not following staffs direction while on the unit he should not be permitted off the unit for any additional activity. Notify the nurse immediately. He is currently on Full Restriction. Again notify the nurse immediately and get involved with all pre-crisis aggression such as arguing, threatening posturing etc.
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Case 1:04-cv-01350-GMS
Ut:LAVVAKt: 1-'0 Document 267-2 Y l-MIA I ~I\..- L.CI'oI1 cn. Filed 04/23/2008
Grievance Form
Page 43 of 54
NAME UNIT:
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In the space below, please write your complaint or grievance, (Use additional pages if necessary) If you need help In completing this form - Unit Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team
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I DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:.
I
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Make a copy of this slgned/d81ed GnevanC
Form tor the patient or lamily Fax a copy of the form to the Performance Dept (255-4418) IMMEDIATELY, prior to the start of the Investlgalion.
-----.JI
8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 44 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAME: UNIT:
-::J I ~y'),'YV),'/ f L...J:.:-v,n S DATE: e 6") !'Jojtni ~3i, -:r.'[ W\ AnENDINGPSYCHIATRIST:~
In the space below, please write your complaint or grievance.~ (Use additional pages if necessary.) If you need help In completing this form - Unit Staff. the Patient Advocate (255.2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team .
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
Make a coPy of this signed/dated Grievance Form for the patient or family. Fax a coPY of the form to the Perforrnance
Improvement Dept. (255-4418) IMMEDIATEL Y, prior to the start of the investigation,
2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 45 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAM E:
UNIT:
::r I rn rYJ.I e.. /..;rtz'/) NO)-11f ":$ :I. t (J(1 '7
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DATE: ATTENDING PSYCHIATRIST:
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In the space below, pleas& write your complaint or grievance.~ (Use additional pages if necessary.) If .you need help In completing this form - Unit Staff, the Patient Advocate (255·2775). or the Dm~ctor of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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Make a copy of this signed/dated Grievance Form for the patient or family. Fax a copy of the form to the Performance Improvement Dept. (255-4418) IMMEDIATELY, prior to the stan. of the investigation,
2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 46 of 54
e
NAM E:
UNIT:
DELAWARE PSYCHIATRIC CENTER Grievance Form
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In the space below, please write your complaint or grlevance.~ (Use additional pages jf necessary.) If you need help In completing this form - Unit Staff, the Patient Advocate (255.2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or 3 member of your Treatment Team.
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DIRECTIONS FOR UNIT
RECTOR/DESIGNEE:
Make a copy of this sighedfdated Grievance Form for the patient or family Fax a copy of the form to the Performance
Improvement Dept (255-4418) IMMEDIATELY, prior to the start of the investigation.
2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 47 of 54
DELAWARE PSYCHIATRIC CENTER Grievance Form
NAME: _ UNIT:
..----:- hi '\:11 t' -J
I
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ATTENDING
PSYCHIATRIST:D'-'iZ~-,--#·D-O-jV-;-llt~lL-ju~f..L:-
DATE:
:; the space bel~w, please ~rite ~our complaint or grievance. (Use additional pages if necessary.) ,you need help In comple~lng this form - Unit Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255·9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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DIRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
~ake a copy of thiS signed/dated Grievance Form for the patient or family
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Fax a copy of the form to the Performance .. mprovement Dept (255-4418) IMMEDIATEL Y, prior to the start of the investigation .
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8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 48 of 54
DELAWARE PSYCHIATRIC CENTER Grievance Form
NAME:
UNIT:
-111'nm /e .
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~-flJJS.
DAfE:
AneND1NG PSYCHIATRIST:
()?
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In the space below, please write your complaint or grievance.~ (Use additional pages if necessary,) If you need help In completing this form - Unit Staff. the Patient Advocate (255·2775). or the Director of Consumer Affairs {255-9421} will assist you. Give the completed form to unit staff or 3 member of your Treatment feam.
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Make a copy of this signed/dated GrieV
2
Case 1:04-cv-01350-GMS
UCL1-\VV1-\r\C t",:, Document 267-2 T ..... nlJ-\ I "I .......... CI'. I L "
Page 49 of 54 Filed 04/23/2008
Grievance Form
NAME: UNIT:
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DATE: ATrENDING PSYCHIA TRIST:
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j:IRECTIONS FOR UNIT DIRECTOR/DESIGNEE:
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Make a copy of this srgned/dated Grievance Form for the patrent or famrly, Fax a copy of the form to the Performance
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8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 50 of 54
DELAWARE PSYCHIATRIC CENTER Grievance Form
NAME: UNIT:
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In the space below, please write your complaint or grievance, (Use additional pages if necessary.) If you need help in completing this form - Unit Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255,9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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I Improvement Dept (255-4418) IMMEDIATEL Y, prior 10 the sIan of the investigation
8
Case 1:04-cv-01350-GMS
DELAWARE PSYCHIATRIC CENTER
Page 51 of 54 Document 267-2 Filed 04/23/2008
Grievance Form
NAME:
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DATE: ATTENDING PSYCHIATRIST:
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In the space below, please write your complaint or grievance. (Use additional pages if necessary.) If you need help in completing this form - Unit Staff, the Patient Advocate (255-2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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Make a copy of this signed/dated Grievance Form for the patient or family Fax a copy of the form to the Periormance l'mprovement Dept (255-4418) IMMEDIATELY, prior to the starl ofthe Investigation
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8
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 52 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAME:
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In the space below, please write your complaint or grievance: (Use additional pages if necessary.)
If you nAed help In completing this form - Unit Staff, the Patient Advocate (255-2775). or the
Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a
member of your Treatment Team.
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DIRECTIONS FOR UNIT DIR.ECTOR/DESIGNEE:
Make a coPy of this sighed/dated Grievance Form for the patient or family Fax a coPy of lhe form to the Performanca
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2
Case 1:04-cv-01350-GMS
Document 267-2
Filed 04/23/2008
Page 53 of 54
DELAWARE PSYCHIATRIC CENTER
Grievance Form
NAME:
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the space below, please write your complaint or grievance: (Use additional pages if necessary ) . .you need help In comphJ~lng this form - Unit Staff. the Patient Advocate (255.2775), or the Director of Consumer Affairs (255-9421) will assist you. Give the completed form to unit staff or a member of your Treatment Team.
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