Linthecome v. Alfaro et al

Filing 10

ORDER DISMISSING Complaint for Failure to State a Cognizable Claim and DENYING Motion for an Injunction 1 ; ORDER DENYING 8 Motion Recalculation of Time ; Amended Complaint Due Within Thirty (30) Days, signed by Magistrate Judge Michael J. Seng on 04/1/2015. (Attachments: # 1 Copy of Complaint, dated 09/15/2014, # 2 Amended Complaint Form) (30) Day Deadline(Martin-Gill, S)

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Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 1 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 2 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 3 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 4 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 5 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 6 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 7 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 8 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 9 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 10 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 11 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 12 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 13 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 14 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 15 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 16 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 17 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 18 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 19 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 20 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 21 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 22 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 23 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 24 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 25 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 26 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 27 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 28 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 29 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 30 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 31 of 39 Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 32 of 39 STATE OF CALIFORNIA CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION Calcuhdion W~rksheet - Determinate (DSL) Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 33 of 39 Worksheet No. of CDCR 1897-U (01110) Access Version (use mUltiple worksheets for mixed credit codes). CALCULATION WORKSHEET -- DETERMINATE (DSL) This form is used to calculate the Earliest Possible Release Date (EPRD) for inmates sentenced to serve a determinate (DSL) term. DSL terms with offense date(s) prior to January I, 1983 are entered into Offender Based Information System (OBIS) as Credit Code 2 and earn one-third credit per Penal Code (PC) Section 2931. Non-violent DSL terms (offense date on or after January I, 1983) are entered into OBIS as Credit Code I and eligible for up to day for day credit per PC Section 2933, (two for one credit if eligible per PC 2933.3); Second-strike DSL terms are'entered in OBIS is Credit Code 3 (PC Sections 667(!3)-(i).fP.C I! 70.12, offense date on or after March 7, 1994) and earn 20% credit; DSL terms for violent offenses occuring on or after September 21, 1994 are limited to 15% credit per PC Section 2933.1 and are entered into OBIS as a Credit Code 4 (or 6 if second-strike violent offense). Specified offenders do not receive credit per PC Section 2933.5 (or when sentenced in conjunction with a murder occuring on or after June 3, 1998 per PC Section 2933.2). Zero credit DSL terms are entered into OBIS as Credit Code 5. Case.Number(s) BA402255 Section B - Recalculation of EPRD (chane:e in credit earnine: status, credit losslcredit restoration, etc.) Section A - Orie:inal EPRD Calculation This is the initial EPRD calculation that is done upon reception. Unless there is a change in work group (credit earning status) and/or credit losses occur, the EPRD remains throughout the term. 4 = 0 YRS MO 07/09/2018 ~inus PRE & Post Sentence _ @PRE II Credit . ff~= 07/05/2015 A3. A4. Minus Vested Credit Credit Code I, Divide by I or 2 Credit Code 2 or 3 Divide by 2 Credit Codes 4 or 6 Divide by 5.66 Cred it Code 5 - Zero (Round Down Fractions) - 11 = "it! ~'~~~"ijit\. A6';:Equals!Maxim.init.Qate I~:.I~' ." j1 .~!;; ill ,. » y ~ \i. . " = % 0 0 DT - MC 06/24/2015 - + = ­ B6. Equals Days remaining to serve as of date credit applied. = 07/08/2014 A8. Equals Days to Serve = - 0 = CC-WG ~~ Equals Projected CDCR Credit 351 A9. Minus Dead Time 351 A I 0, " B3. Plus Net Credit Loss (See E 1.) Leave Line B3 Blank if Credit Code 2 B7. Divide Line B6 as follows to project CDCR Incarceration Credit Credit Code 1: WG - AIIU/A2/B/DI divide by 2 WG - F divide by 3 then multiply by 2 Credit Code 3: Divide by 5 Credit Code 4 or 6: Divide by 6.66 If change in work group, credit loss, Reeves, MCC, etc., stop here and proceed to Section B l' ­ , Note: Credit Code 5 (zero credit) calculation stops here. A7. - Day Before Start Date (Line A I) B2. Minus CDCR Incarc. Credit Earned (See Reverse) 06/24/2015 + AS. +Dead Time/-Merit Credit PST = B5. Minus Date Credit Applied Through + A2. Plus Time Imposed ly1"M...i:li...cl;',J(l. .....:;..s~ amounts of credit (2 decimal pts.) .!!.p.p!.y. whole amounts only; B4.EqualsCurrent Release Date (CRO)· Calculation ends here if: -Credit Code 2, 5 -Credit applied is to the CRDlMax. Date Carry date down to Line B13 07/09/2014 A I. Start Date £ previously earned and projected future credit. Record fractional IiA~,~aximum,Dat~'(~Jn'l;~A,6),'~ii:v:fjj!l~;~\t~d Credit Code 1 ~<\ Step 1: Accumulation of CDCR Incarceration Credit for days = Days where credit may be applied B8. Total CDCR incarceration Credit - Accumulate Fractional Credit Line B2 A14. Equals Original EPRD = ­ B I O. Minus Total CDCR Incarc. Credit (Line B8, round down) B II. Plus Net Credit Lost (See E2.) + B12. Minus Milestone Credit (Sect. FI) 17_~ vi:~2/3n201~ (include fractions) IB9; ~~~m.~~ Dale (i£i~{p·!'l;~~)~i±;~:::~l 06/24/2015 - A 13. - CDCR Incarc. Credit (Line A II) 0 (include fractions) Line B7 0 + Step 2: Recalculate EPRD A II. = CDCR Incarceration Credit by dividing Line A I 0 by: Credit Code I - Divide by 2 (round down); Credit Code 2 • Divide by 3 (round up, also see section G) 175 = Credit Code 3 - Divide by 5 (round down) Credit Code 4 or 6 • Divide by 6.66 (round down) tll!}:,M~~Jlli.!fgf~~;(41'ii~~l,~):l,'f: iO':';,J = ­ HI3. Equals Adjusted EPRD * = • The CRD is an intermediate date and may ; ') exceed the maximum date; however, the 15f~- ~A Adjusted EPRD cannot exceed the maximum jJW J)\ - Mixed Credit Codes (When the conse~uti~e terIh is' Credit Code 32~nl~) 1",e1ease dltV Section C () . When the adjusted EPRD is later than the Maximum Date, CDCR credit earned must be calculated to the MaXimum Date (record on Line B2). Subtract credit earned (Line B2) from Net Credit Lost (Line B3) which equals the excess lost to apply to Credit Code 32 term. 0 Cl. CDCR Credit Lost (Line B3) C2. Minus CDCR Credit Earned (Line B2) - 0 C3. Equals Excess Credit loss to apply to Credit Code 32 term (record in Section G) = 0 I I-CALCULATEDBY (Name & Title) M.. ALEJO, CCRA INMATE'S NAME LINTHECOME \1 1 CDCR NUMBER AT9688 DATE 07/18/2014 ILOCATION NKSP-RC "'~1'.. '7 .~.( ?"\ .-:;::.. 5 L\),) . G . /;:\~ '\' ~ . - \\. Ji\S Case 1:14-cv-01438-LJO-MJS r IlFFENI.lIIN O~ ,< . • ," f\1{1I 1\()H0511'22 CIINO ~ IIOOKING NO \ ( Hi5,IXlU FI IONY or JUllGMl::N r Li)'X\i\i_'.r {O'i " \ 17,1 P~~SON_C~TM!~I ~~Y" _I /' .f9 n("m 11-05-71 Document 1 Filed 09/15/14 Page 34 of 39 MARCUS LEON LlNTI·IECOME ~~,'J) , , 1\1'-HJt,LI.:S f'E.OPLEoFrJll:srllrE.oFclluFOrmV\V$. __ I-:J COUN1Y -0 ____ .._ ..___ . ~ 111\1'1: OI-f{r:lXl"NCi....:J // II-05·1} ) / 1- - - .-__ "."~ ' - . ',-,---CLCIlK IM~,tr:.DJ,,'\:J E SEI,n ENelhle i-TiTF;Tlnl~';I1 'J'(') I N()~~'m ()7;\ ;;, " --;J \\ -~ ~_ \ -s' C~\I \. r-:' r',/ ~. ~N/ . . ' 1 i; "~I -;". - '---. J.t.y. --ro &> - IV jIItft,(j iii 1,1 I\llmllcied Urt]c,r ~: ," =7-/Pl' /V/C;I;jJ- J. I ' , Supersedes Order 01. __ . __ .-.. ___. ___ . __. ',j ,... _----,- - " _I DEFt' I I /\'\ ; ,.r (,i ~' [J I \.~ t;£\ . , '(/~: p"u e _.,.'::':" __. 01 .~\,_,.I.:_ Pl\pr.cr~;3 OHIY '\. "_~ 'f ~-i3' .--:,' -,/.- " "'.> --"'. ..t;.>•. >L . . .'... "':I _' / -"_.- ':-_"._.M._.__ f· 80Cl!<IN(; NO. 1E ( \. . "1"\ . (. .' _ I "\ i ~UPERIOR caUl\., ai" c/\r:n-(}HNIAi CQUNTY OF LOS j\NGE:LES , ~.~t 'et~.'~COMMITMENTCJ, STATE PRISON, ME~\jTA)_ I)EAL T,H OF{ D,JJ _, .((d<;o ~~, \O¢.. ' , . p/1---LI02-::!., S ~ /I-Z() - /2 'II JJ "r' _ ), . . ' " --_. \,:;. Y.>, n,;l(" ~ !14\~-~ \ -v----- 'i J' s'" I' Dq!3~«_7 7. I(- I <'-/' -> 0. I' ...c­ '0 y ~,,--.~ ­ ~ .~ hf'fnn:; COUNTY; Tlte Ille ,jllli<,JllIenlllClving h,,'el'l lile cldoml:'UlI ,conlinc(\, f,U, .~~ ~ 1,1 C~'.·" ~ \1 ,,,'. CONVICTED ill the Hh(')Vl:r-!"I,ltlled coun 01 fj Ie pin:. 1~). DEFENDANT COMMITTED TO:)~:'STAri: pr<ISOI\l CI COUNTY J/\IL - I] IVIIS!~ FEtOr· V .vU COUNT NO. ~J iucl~]e 01 s(Iid COlii'I I It,,r,;,!lY cerlily !Il" iore}Joil H,/ "lHI' CI\SI'S I3FI:'OVl/I-I/\V[.fJ,EEI\l 11fj I'-:;j:?.:zc~ l~--" l\lull 1'(_:11 ..,. . ()I r:! C'I .1/\11. (PC 1·1·,'n(I','.1 I.J DEPT OF MEI\lT/\L HLl\l.TH .. '___._" '1~~ ~~~ ~~ ..J I')' p,r,E-SENTENCE CUSTODY CHEDITS '"l1,'("~:;:}t)Ui-I' . (Complete . '" Hi, FOR THE TEI<M OF: __.....-..,,__ rJ.flYH-~·M1"TI'H',: 17, TO RUN CONSECUTIVE TO: [11\,1\' Olly"r C;ls;e ' D;1y~1./ I() t){lg.L.':l_.~l'nc" i(.les :rrf._.G·! WT U;;!Y.~; '.~-,.,." [] Sl1eri[llu I)~le!nlirl~)I;II (Mise! only). Ac!ucll DAY~;1~LL" f ': l!I .. , II\r.l"ll'~[)I,"r.r:r'I" 5-1"'\\/1"1-) 1'0' t I~JI., \tI)llL, I ' .. I I " 4. Defend::HlI selilenceci " pel PC 66J(b)·(i) -L,.;- r-! ,i;:lil ifl I.i{\u c)1 Fipp n,:.:!(1\,\, __ ._~ _ _ _ _ _ _ ~~ _ _ _ "_' 10 county j3il pN \1 tlr C<JSO 1"0. ,, __.,,______ , __ , JAIL ,,~ LIEU OF FINE: [l Cnlll!! 1'[,' .: {1-t'-pI '-:'2/.;/' I ,") If· 1-,;:",.) 10 prison perl170(al, 1'170, 1(a) ort ' Ii /7, -'H'-.!\J.I·:~{t1c.:q'!:'1I ;"" l..U(' l.'ltl T),4- ,(' II~ ~ ' ...... ,,--.-"--f~;ly .L. .(._, :0.~. tt (rr clue 1(1 i : ! P;IY ._. __ ... , _._, __ I::-ill(j (!( D;:ly:'~ SI.:l! \/\'; if I ,jail ul t! 1(~ n::lle Flf~:1 L);"\y o! I " I i I I ~. ~;) r,~ I~al(' t:verv $ 1(:1' ! !!!eJi:.,J"'· (:1) LJ currel1! or prior seriolls or violen! felollY f'C 790 or r:'.C '1 ilG. '11 ;"I1Ii:1I1,Plllenl PC 1170.12 (strike plior) per PC 1170(il)(3)' Precolliinelllenl credits equal I (.j I: I Felony ProbAilon Viu/'i:i"n [] Mise! Proi>alion VioL'liir;n . .2' -t::;-­ oi, ex=c:p:~_(~'d~til~n~e~j~l1l:lJ~o~~_pr_i_ .._I______'-"-----~~-------.I-_ ~~ ~ f;~ f!l ~ As cF ,I ('4 ( lA-/, iVl JCt-(L g-/22IVt Case 1:14-cv-01438-LJO-MJS / I I Document 1 Filed 09/15/14 Page 35 of 39 'S/V1ce " 1/ t I : /7;"t>, // l ,., '~l/ ~/' :r~ f. . /J fI' r' Los Angeles County Pmh;ltinn Department Pretrial Services Division Early DisllOsition Criminal History Assessment 2 3 Casc Filing 41 Filed Name: Apillicatioll: M00042795 Court Date: "~.-Court: ,,' " ,S 12/07/2012 LAC034 Case Numher Level Description BA40225S-01 F TRANSPORT/SELL/ETC CONTROLLED SUBSTANCE Arresting Agency: ;I~ 1011 Dcfcndant Infonnation Gender: I Race: 110M A8684705 11/05/1971 BL."l\CK '" . . ' "."...... : On File ....., 1 DcfcllIl:mt Cdmin:.1 lIistorv Summ;u'v: 131 Main Number: I Cli Nurl1be-r:-L'---­ 01328433. 1411-8- - - - - ­ AOB051122 Juvenile Sustained Petitions: X Number: FBI Number: LAPD Number: Probation 254918MAO 2407782L 1451499 ' Felony Convictions: 1 Misdemeanor Convictions: 16 161 GCllcnl1 Comments: 17 LAW ENFORCEMENT INDICATES THAT ~HE CRIMINAL IDENTIFICATION NUMRF..R IS BASED ON A POSITIVE FINGEI~PRINT MATCH. 18 HIE DEFENDANT liAS A "NO RAIL"PAROLE HOLD, CDC#: VS0649 OFFENSE: HSt135L5 OJSCHARGE I)ATE:POSSIRLKPA.!.tQLEEAT LAR,GE ,/" · Page 1 of J Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 36 of 39 CDC;:: AT9633 ....... ,__._---' Summary----------------------------------·----------------------------------.-~ Offender/Placement - . _ - ­ CDC AT968S Neme: Disability/Assistance -------., LINTHECOME, MARCUS LEON 1;:5titut~or. : D?P Codes: North Kern State ~evoc=ti')n: No [Hi5tO;y~ I 1845 Dare: Prison D 003 1102001LP "'HS::JS Code: 71 Custocy Level: Important Dates - - - - - - - - - ­ Pending CDP (oce: [Other] CCCMS SLI: Unclassified Ai:err:at~ RC - Recept Ctr Le::~"iilg Disabi1J\:y: TA=:; S':Jle: P.t'iTI? Gescri;::tlor:: Kegui=r DE!'! Off: Wo;-k Hot.:r5: Accommodation History ..---..- .._--.---.----'---.:----..--.----.--.-... -----.-----.~------.------.---------~ No Accommodation Records Found. I /, (t) :/l > / , ) / 1/ I • V ( (-~ Los Angeles County Sheriffs Department Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 37 of 39 Inmate Medical Documentation froM 7~ 2. ·~J3 \,,~ }( . . \2--t'S :r ~ A<;:A\ t"A,'i:'t:>\'l1l CHI,' CHU-HSIANG /PHYSICIAN SPECIALIST MD219829 Entered on Provider Form Soap_Provider )j )~/ :,\.~d~ . ;. . \ 0: 02~pm:!--_",,",\"_ _ N-..01--.: j' PATTON 'TRANSFER PAPER NOT ATTACHED TO CHART FOR REVIEWING PT DENIES HX OF MEDICAL OR MH PROBLEM DENIES ANY DISCOMFORT NOT TAKING ANY MED AT PATTON PER DATABASE '1C1 'trAYS' 0: ~D TO B~~CH, HANDCUFF BOTH HANDS BEHIND H BACK ALERT, AWAKE, IN NAD BP . 94,MG/DI; A: AS ABOVE \ Appointment Type Evaluation Type P: \ MONOTOR BP . LOWER BUNK HOUSING PER MENTAL HEALTH Scheduled Provider Encounter * Provider Prog:r::.sii~·.Notgs 08/14/13 11:12 am performe~ by Choung, Joon H. / Physician specialist M:D. - 514464 Entered on 08/14/13 11:15 am Provider Form Patient Location_Provider Problem_Provider Soap_Provider Appointment Type Evaluation Type Tower 1 SWELLING AND PAIN OF RT HAND. PT COMPLAINTS OF PAIN AND SWELLING OF RT HAND SINCE 3 DAYS RT HAND:SLIGHT SWOLLEN. P: X-RAY OF RT HAND. Unscheduled Provider Encounter Provider Progress Notes 08/27/13 12:06 pm Performed by SADDLER JR. MD, RALEIGH H. / PHYSICIAN ­ 457433 Entered on 08/27/13 12:13 pm Provider Form Patient Location_Provider problem_Provider Soap_Provider MCJ head blunt trauma reports injury to the head 41 y.O. B/M hit against ,his bunk this incurred when tet tox inocc last p.m. The last received\ app: 2 months ago. PE:Bp 98.7F Printed By: ' JUNIOR, BRENDA K.! HIM 454264 Print Date: 12/12/201311 :07:55 AM Page: 15 of 22 122/ Inmate Name: ell Number Booking Number: Booking Date: Date of Birth: Housing Location: 61 P 67/min temp LlNTHECOME, MARCUS A08051122 t A",\ C' I"~ 3654883 i~ e"vv ~) ~ 8/12/2013 3:44:00 PM 11/5/1971 42 years 3100-C 0003 , (}J1ce,,:I S'aWAAlUr~.,~ 5~/q,.¥. &-S'ee?l /A.!4'jJF..PX,,3~ ~;z::, .AMtlf.oA)Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 38 of 39 1fW(1Jlt1~;Z,-.iJZ.~·~~r-S:/lp~'/5/~J1d/& ~s/7~t.#/f/soZ STA~JOF- CALIFORNIA Neett t:?1C. ~ W(;i..&/4:1't REASONABLE MODIFICATION OR'INSTITU~ I AROLE '. ;1~;O ACCOMMODATION REQUEST CDCR 1824 (Rev. 10106) IN.~A~PffiqLEE'S ~~(P~Ny/) /J ,1v//J//ncC;O¥t:r :. FC '. / G :' lrA,I?I1/ A :t4 0 18.ADA I ~/' . is TO BE USED ONLY BY INMATESiPARQLEES WITH DISABILITIES NOTE: THIS 'FORM ./ EFl, GI 'I ~r ~I C~ /J4f4KCi/~~ 7r/-~ " "I HOURSIW TCH /f//lf NMENT , HOUSING "" '2,L ,(),~~/O : In accordance with the provisions of the Americans With Disabilities Act (ADA), "no qualified individuals' with a disibility on the bas!sof disability, be excluded from, participation in, or be denied the benefits of the services, activities, or programs of a public en~ijy, or .besubje.cted.to_.discri!11ination." ". ,. :. . , " ." ' , ," ~ ","- . " 'You "may· u~e this' form to request specific reasonable modification or accommodation which, if granted, would enable you to participate in a service, activity or program offered by the Department/institution/facility, for'which you are otherwise i qualified/eligible to participate. Submit this completed form to the institution or facility's Appeals Coordinator's.pffice.. A decision will be rendered within 15 working days of receipt at the Appeals Coordinator's Office andtt'le completed form will be returned to you. If you do not agree with the decision on.this form, you may pursue further review. The decision rendered on this form , , constitutes a decision at the FIRST LEVEL of r e v i e w . , ~ To proceed to SECOND LEVEL, attach this form to an Inmate/Parolee Appeal Form (CDC 602) and complete section "F" of the appeal form. . " . ' shall, ,...... , . Submit the appeal with attachment to the Appeals Coo,dinator's Office within 15 days of your receipt of· the decision .. ' _."' " rendered""on this request form. ' " If you are not satisfied with the SECOND LEVEL review decision, you may request THIRD LEVEL review as instructed on '~the CDC 6 0 2 . ' ' ' ' " " . ". , . . ." "' :',. ! ,"'. , ( ""'. , Case 1:14-cv-01438-LJO-MJS Document 1 Filed 09/15/14 Page 39 of 39 ' , :' , "-REASONABLE MODIFICATION~'QR ACCOMMODATION:,REQUEST GDCR 1824 (ReV, 1010f?) , , _--,-'-=~'_' ,:<--1 ":.,, _"_--'-'-_ _ ~ __ ! Page 2 of 2 , -,-----,----,-:....-R-:-E~VI_E,--,-~~,~=-~=-~S=-'A=-C=-T=-I=O-=N-=_':::=-=-,====================~I~~ I'DATEASSiGNED TO R~VIEWER; TYPE OF ADA ISSUE :'I.DATEPUE:,'" , . PROGRAM, SE~VICE;.bR ACTIVITY ACCESS (Not requiring structural modification) " ,I: , -'~" Auxiliary Aid or Device Requested .:........ , -­ '\ -----'---'-----'----'------'-~~..:,..\.--\:....\-,----,.'--"-..;..,-" ~\ ' " D \ , . , , ,} .~ . .. PHYSICAL ACCESS (requirirg structural modification) , , ' DATE INMATE/PAROLEE WAS INTERVIEWED PERSON WHO CONDUCTED INTERVIEW DISPOSITION \ . DENIED PARTIALLY GRANTED GRANJED BASIS OF DECISION: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~-----\-'_ __ , , \ , , , NOTE: If disposition is upon information provided by other staff or other resources, specify the rftsource and the information provided, If the request is granted, !Specify the process by which the modification or accommodation will be provided, with time frames if appropriate, , ' " ", " ' , ', ,' , "~', " DISPOSITION REI'JDERED BY (NAME) ! I INSTITUTION/FACILITY "r'rrLE" i APPROVAL ASSOCIATE WARDEN'S SIGNATURE DATE SIGNED DATE RETORNED TO INMATE/PAROLEE , .' " \ ," \ \

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