ABC Secure Juvenile Facility Seclusion / Isolation Log Type of Seclusion / Isolation: Protective Isolation (§343.290) Disciplinary Seclusion (§343.288) Medical Isolation (§343.338) Assessment Isolation (§343.402) Date Time Date Date Seclusion / Seclusion / Name Unique Identifier (i.e., Seclusion / Seclusion / Reason for Seclusion / Isolation Authorized Isolation Isolation Of Resident PID #, DOB, etc.) Isolation Isolation Comments By Began Began Ended Ended Page ________
ABC Secure Juvenile Facility Seclusion / Isolation Log Type of Seclusion / Isolation: Protective Isolation (§343.290) Disciplinary Seclusion (§343.288) Medical Isolation (§343.338) Assessment Isolation (§343.402) Date Seclusion / Isolation Began Time Seclusion / Isolation Began Name Of Resident Unique Identifier (i.e., PID #, DOB, etc.) Reason for Seclusion / Isolation Comments Authorized By Date Seclusion / Isolation Ended Date Seclusion / Isolation Ended Page ________