Review of safety order form

1. Safety order details

   1. Prisoner's first name *
   2. Prisoner's middle name
   3. Prisoner's last name *
   4. Location* Select an option Arthur Gorrie Borallon Training and Correctional Centre Brisbane Brisbane Womens Capricornia Helana Jones Centre Lotus Glen Maryborough Numinbah Palen Creek Southern Queensland Townsville Townsville Womens Wolston Woodford
   5. IOMS number*
   6. Commencement of safety order * Example: dd/mm/yyyy
   7. Expiration of safety order * Example: dd/mm/yyyy
   8. Safety order type Select an option Initial order Consecutive order
   9. Commencement date of initial order* Example: dd/mm/yyyy
   10. First name of official visitor *
   11. Last name of official visitor *
   12. Official visitor email*
   13. Date of completion of official visitor review* Example: dd/mm/yyyy
2. Approval of safety order

   1. Has the safety order been approved by an authorised delegate? *

      • Yes
      • No
   2. 1. Approving delegate *
      2. Approval date*
   3. Comments
   4. What are the reason/s as stated in the Form 5, for issuing the safety order?

      1. A doctor or psychologist advises the chief executive that the doctor or psychologist reasonably believes there is a risk of the prisoner harming himself, herself or someone else.
      2. The chief executive reasonably believes there is a risk of the prisoner harming, or being harmed by, someone else.
      3. The chief executive reasonably believes that a safety order is necessary for the security or good order of the corrective services facility.
   5. Reasons*
   6. Are you satisfied that there are adequate grounds for making the safety order?*i.e are you satisfied that there is evidence that the prisoner is a risk of harming themselves or others or poses a risk to the security or good order of the facilities?

      • Yes
      • No
   7. Comments*
   8. Has a doctor/psychologist provided the necessary advice to the delegate prior to order being issued?*Applicable only to safety orders pursuant to section 53(1)(a)

      • Yes
      • No
      • Not applicable
   9. Where is the prisoner being accommodated on the safety order?*

      • Safety Unit
      • Medical Unit
      • Detention Unit (powered)
      • Detention Unit (unpowered)
      • General Accommodation
      • Maximum Security Unit
      • Restrictive Management Unit
3. Conditions Are the conditions that apply to the prisoner under the order clearly stated?

   Extent to which prisoner is separated?*
   • Yes
   • No
   How and when the prisoner may receive visits?*
   • Yes
   • No
   Amount of property and access?*
   • Yes
   • No
   Access to activities, courses and programs?*
   • Yes
   • No
   Phone calls and/or other electronic communication?*
   • Yes
   • No
   Have any special needs been highlighted on the order and are they being met? *
   • Yes
   • No
   Does the prisoner identify as Aboriginal or Torres Strait Islander?*
   • Yes
   • No
   Have the requirements of the Corrective Services Regulation 2017 section 8 been actioned?*
   • Yes
   • No
   • Not applicable
   Has the chief executive informed the cultural liaison officer?*
   • Yes
   • No
   • Not applicable
   Has an Aboriginal or Torres Strait Islander elder, respected person or indigenous spiritual healer appointed to the facility been informed?*
   • Yes
   • No
   • Not applicable
   Has the person nominated by the prisoner as the prisoner's contact person been informed?*
   • Yes
   • No
   • Not applicable
   1. Comments
   Is the prisoner receiving the conditions/privileges stated in the order?*
   • Yes
   • No
   2. Comments*
4. Reintegration

   1. Is the prisoner being provided with any reintegration opportunities?*
      • Yes
      • No
   2. Comments*
5. Procedural fairness

   1. Has the prisoner been provided with procedural fairness?*Pursuant to Corrective Services Act 2006 section 54(4)(a)(i) and (ii); and 4(b)
      • Yes
      • No
   2. Comments*
6. Reviews

   1. Is there evidence that the prisoner is having a medical examination by a doctor or nurse every 7 days?*Pursuant to Corrective Services Act 2006 section 57
      • Yes
      • No
   2. Comments*
7. Communication with staff

   1. Have you met with the key staff associated with the management of the prisoner concerned under the safety order?*
      • Yes
      • No
   2. Please state the reasons*If you chose 'No' above
   During the course of this review I met with the following personnel to discuss the particulars of prisoners Safety Order*
   1. General Manager/Director
   2. Deputy General Manager/Deputy Director
   3. Correctional Manager/Supervisor
   4. Manager Offender Development
   5. Psychologist/Counsellor
   6. Other
   3. Comments*
8. Interview with prisoner

   Comments*
9. Recommendation

   *

   • Confirmed
   • Amended
   • Cancelled
Factors and reasons for recommendation*
Official visitor checklist
* I confirm that I have:
• collated and considered relevant as opposed to irrelevant information.
• double checked to ensure correct information - eg. offender details and history etc.
• findings and recommendations are supported by evidence.
• double checked to ensure correct spelling and grammar.
10. General manager email

    1. General manager email*