HomeMy WebLinkAbout95-00832
MENTAL
HEALTH
CASE #
5
199. ~3~
1l"
.,...
--."'1,
l ,no
. 't
?eti:ion for ~~volunt3~' 7:eat:ent
via the C~i~nal Justice System
~ental
(Sections
Heal:h ?=ocedu=es Ac: of 19i6
304 and 305 via 403, 404 or 405)
q.r-
ri:St
~liddle
53)-
Age
C, 11 liT
.
~711e blanl:s below :laY be cOlll1Jleted
Je or ?at~ent Last
jt/rt'Gfo
~e or C.Junty ?=OgT3.111
:ollowin~ arl~ssion.)
je:l
4t!o/.,0
.3,/
/If
Adm:I.SS10n Date
AalD1SS10n f
~e of ;:acUity
Admission Oau
Aa:!Uss:.on f
sc.. \ - ("",,\) \\\\..L..
c ~ Od?><d
InstTUctions
1. Part I, the petition for order of the court, is to be completed by
the director of the facility (or his authori:ed representativ~)
where the patient is cur=ently incarcerated, the attorney for the
Commonwealth, the defendant's counsel, or the County Administrator~
2. Part II is 'to be completed by persons authori:ed by the director of
the facility to explain rights to patients, if the patient is current-
ly in treatment. If the patient is not currently in treatment, it
should be completed by the penal institution or the patient'S attorney.
3. Part III is to be completed by the examining or treating'physician.
If the patient is not currently in treatment and has not been examined
by 'a physician, this sec~ion may be completed on order of the court
under Section 304 (c) (5) of Act 143.
4. P~ IV is to be completed by the court if u~e of this format is
desired.
5. If additional sheets are needed at any point, note on this form the
number of pages which are attached.
6. If the patient is currently in involuntary treatment, attach a copy
of the treatment plan and a copy of the 304 form, prior to tle deliverl
of this form to the court.
IMPORTANT ~OTICE
AlN PERSON WHO PROVIDES AlN FALSE
INFORMATION ON PURPOSE \VHEN HE
COMPLETES nllS FORM MAY BE SUBJEcr
TO CRIMINAL PROSECUTION ~~D MAY
FACE CRIMINAL P~~ALTIES INCLUDING
CONVIcrION OF A MISDEMEANOR.
-1-
:-'i 786
. --
J- I ,
Part 1
PETriION FOR ORDER OF TOE CCURT
.'
;(:(,/Olh ,1.'/17.1<:..'
(Name Ot Patlent)
to cause me to believe that he is severely
~e has ceen examined by
and was found to be in need
nas acted in such a ~anner 1S
mentally disabled.
;::;;j; ,f /J? hi r ft~
(Name or Physici~)
or t,:,eat:nent.
c:J He has not been examined by a physician, but I believe he is
in need of treat:nent.
I, therefore, re~t that: (Check and complete A, a or C)
A. CEJ As the patient is not currently in a mental health facility
(304 c) receiving treat~ent, I ask this court to issue an order that
the patient be involuntarily co~~d for: 0 outpatient:,
c:J partial hospitali:ation, inpatient treat:nent. (A
patient can only be committed involuntarily if the ~atient
is severely mentally disabled. A person is severely mentally
disabled if:
The patient inflicted or attempted to inflict serious bodily
harz on another and there is reasonable probability that such
conduct will be repeated unless treatment is arforded; or
The patient has acted in such manner as to evidence that
he would be unable, without care, supervision and the con-
tinued assist~ce of others to satisfy his or her need for
nourishment, personal or medical care, shelter or self-pro-
tection and safety. I believe that there is a reasonable
probability that death, serious bodily injury or serious
physical debilitation would ensue within 30 days unless treat-
ment is afforded; or
The patient has attempted suicide and there is reasonable
probability or ~other attempt at suicide unless treatment
is afforded; or
The patient has severely mutilated himselr or herself or
attempted to mutilate himself or herself and there is
reasonable probability of self-mutilation unless t.eatment
is afforded.)
,', ,j",,\ ~l'. -\ ,r \'t' -; ,( " 0\'"'''''' b, ( ('Ill ~ <"::Ii' \-c ( ~ (~
the behav10r or the patien within the l t 30 days wrtlcn
..- ,.-.
.:),~'\c~""\\'(\\ C",C'. 1I",,(f,\\\ l\~l ',)1',. '),'',,) \', ") ('tA\,. \w <,
causes you to believe tha~ he i~ severely mentally
U,l C'1\(.\t \\l ."\"'1 (' \~J \('\-\1' I,l, \,'\1'(\\(1\-\-11'1.21.
additional sheetS i: neces~ar/.)
'-
-2-
con tinued on page 3.
~IH 736
. --
J-' .
r:1r": !I!
RESULTS OF E:(A.\lI~ATION A.'iD DETE?\I!:IAiICN CF :reE:l
FOR (CaNTI~ED) iitEAnlEm
(Statement or Physieian)
I hereby affi~ that I have
on '}/I//;,(' to deter.ni.ne if he
(Date)
disabled and in need of treatment.
[c::r;x:1l:lined CJ reex3.lllinedjfJ.(~/t t.t/lo
~ (Name ot ?at:.,
[l:::::J is i 1 eonti~~es to be J severely :nentall:
ResultS of EX3.Illination
(Give eOlllplete details of exacination. I: rllquest is :or 305 -iescribe de-
tails giving evidence that the patient relllains a clear and present danger to hi:nsel::
or others and indicate how this is least restrictive treatment setting possible.)
Findings: />-.I(';5c)<~.. .;:::;::-;- .hN..,~,. ,//, hI-
in cie 1: a1.1 , inclu ing your t:'.nciings Ot se
/ l:.<I{ M If I/rl~,''''~'(? -;; uc/. 1;7';; }~;.-/ ..j;...,,,,,,,/-..y "e...-
lIle al ciisabili1:Y. Use addi1:ional sneetS it necessary. .
Al't:fI"CP 1r"I.( . /It'!W:;11 '" f, ///.!: '1"'- k/..",r"" /) ..1'?........--...-',..c. "U?' f,)- /,</;0'10;. ,
~.~ cJ . ,
-; /Y/,f>.'S '. IK 15 .nl!-' /;::/f...... /,,'r" .j" /u s VI/. pv,...~ ~
// <- ~ I ~ I- "'" "'e'er, /-0 ,J <h,,6~
I' /,., .I" ~n1U' /1""',,,1 ~_",,,,' ..".;,./0, .:- (.. ,~, /"' /1'"
;'''ff' k./ )./ p:"',h,~..Q;7., o/r~ ,-.).. /a.I';rl:!J-.
T'rreatment Needed: 0~ (.7
Describe tne trea1::nent needed by tne pa1::1ent.
'..
'J '/c:INMC- r;.'....
Use a
....--
~ ,/J I-:!/til
:1tianal snee1:S 1: necessary.
;:j.,.;/}rh"I'/"/c /)wo.p:,- f;1(, /'-"J /f'c:/7"7
/)1//r~t( I 4//1//1 tl //r0~,,/e') ../tC/vv'l-
. ,,1'
dt/ )/,
,
.h.....~ r~ ,!~~/";., S
/Jk,""""~' .~r::t~/I/..fdvf
I '
In !If'( o~- (Check A 01." B.)
A. ~ ~e .pa~ien~ is severely men1:ally
of (condnued) treat:!len1:.
disabled and in need
B. 0, The patient
;lId !./.,./
(/ l/"/-
'(Oa1:e)
is not in need of involuntl1~1 tl."eatment.
- (e{7:eC;02:CV ~AI !~
lSignature or ?nYS1Clanl
/
5~--- (~1 ;"~y" //; 1/
(Address) I
_,1-
CR!lE? FOR 1~'VO LtI~r.,~':' 7?EXi;.tE~rr
Checx one:
l2J Order for involunt:l:"'/ t:"eat:1ent under Section 30J.
0 Order for involunt:lt"'/ t:-e:lt::lent under Section 305.
.
In the Court' of C 1.'V\-1/111\"\
,[1 "
i 'l.< tV1-
of C"^"",, J,J.H.L/~--J County
COllllllonwealth
vs.
~Z L\ ~t u-1.{-" L J 1" ( (Lv
~o. (} \,--
ter:n. 19_
c.-:'-:'-'~ T~/\...-1-'h
II '
, (I-,
This I Y day or _rdJ r IA--I\..'; ,19 '1\ - arter heari.,g and consid-
eration of ". ~W-~t~ v ~'c... u~'d
Detai s or rindings. Inclu e etails on wnat types and why t:-eat::lent
L 1 l-
I ' { 1-.,.'.j. I. A
C _~ / v<4.. _~ (~~\;V~ 1',",-,,">,\
need d Attach reports, te timony, etc.) v
, . __i~ /t~' r -t~ 0-- 6. /J-f Gvvvl ~ A~.1/{ ~dl?
..
"The "court finds that the patient [rRl is 0 is notl severely mentally disabled
and in need or (continued) treatment. Further, after~earing and consideration or
~ ~ ~~ ,,{ ~'d.. ~
"
ab~litY or rac1.ity to
(~{ M
r1ty nee s or patient
(\..RA (~C~ ,A,.#.- ~
proV1de nee 1 ty. Attaclle reports, test1mon ,
A-wi; 1 ~ -4"1' ~t J.;~'J'" ~ [tV' i.. Lr..
.
u~4"" I
The court orders
that: (Checx A. or B)
~ ~\~t-i G"\J.A'~ receive: 0 outjlatient.
(Name or pauent)
o partial hospitali:ation. l3J inpatient treat:llent. which is
the least restrictive treatment setting appropriate fnr the patient
"V\J!~ S ~ i.n,.p /J-vIJ.. /\JA~
Description of treatment, e. lanation or ltS adequacy and appro-
lj ,\~ t~
A.IKJ
M vt-I.., iJ.. I'/~ :.A,,-J,
pruteness. ) I I
t t'AvjN) .yt-vuz I
as a severely mentally disabled person pursuant to the provisions ~
Section [CEJ304 .305] of the ~tental Health Procedures Act: 0:
1976 rot' a period of ( l- . ()lot to exceed 90 days unles
(~ or dOl s)
cor.u:u. tt::J unde r Section 30.\ ll, i. .1lld ii.)
a.s follows: ( Indicatei: c:i:ninal c!la::;e5 are penC1i:lg, '~hether
$entenc:e has been :.:ccosed; i: so, :~n;;:~ 0: sen~e~ce, ',.,i1et.~e:
subject to d.eta.i.ner,' etc.)
.'
.'
~~ /f~u {~
\^^^.I {~
Y''''''4 a
~ ,//111{\ ' zt
11-/1191"
Therefore, upon discontL~uance of ~ental heal~, t::eat~nt, the
__ ,:ollowing disposition of this patient shall occur:
I-J-< ~-(-te ~ ~ ~
( CI G~ 1-/..-"fJ
J&:l
(Chea if appropriate) The Mental Health facility :nay retain custody
of this patient for a rea50nable period up to 72 hours fOllowing ~'e
colllll1itlllCnt period Wltil post-treatment custody is assumed, a5 "indica-
ted above, by the indicated person, facility or court.
r
1;.,
B.O
Other:
i
I
I
I
I
I
,.
I
t
I
I
!
(Check apprcpriata block)
I3J The patient was represented by 1Z",{t.~rf.I&~1 ;;.',/'! (,~~ (', PI)' 170 Ii'
(Name and Address or Attnrney)
o The patient declined representation.
- _.. . ...-.
n
J;;1 the
! ~ /' "'J: I
COUrt -J ' 1,( /C--:;.I k':"-' () . I r,
. ~ 1-
..i ,
(Title;
\..
-6-
:':H 736 ..
,:1, -uI)U\.\"
\,UV, 'r oL.'
C\'\ l) L ,;=:;
BILL OF RIGHTS
, YOU HAVE A RIGHT TO BE TREATED
, WITH DIGNITY AND RESPECT
YOU SHALL RETAIN ALL CIVIL RIGHTS THAT
HAVE NOT BEEN SPECIFICALLY CURTAILED BY
ORDER OF COURT
1. You have the right to unrestricted 'and private communication inside
and ,outside this facility including the following rights:
.
a. To peaceful assembly and to join with other 'patients
to organiz~ a body of or participate in patient
government when patient government has been dete~ned
to be feasible by the facility.
To be assisted by any advocate of your choice in the
assertion of your rights and to see a lawyer in private
at any time.
c. To make complaints and to have your complaints heard
and adjudicated promptly.
b.
, "
. ,
d. To receive visitors of your own choice at reasonable
hours unless your treatment team has dete~ined in
advance that a Vlsltor or visitors would seriously
interfere with your or others treatment or welfare.
e. To receive and send unopened letters and to have out-
going letters stamped and mailed. Incoming mail may
be e:xamined for good reason in your presence, for
contraband. Contraband means specific property which
entails a threat to your health and welfare or to the
hospital commun~ty,
.,
f. To have access to telephones designated for patient use.
2. You have the right to practice the religion of your choice or
to abstain from religious practices.
3. You have the right to keep and to use personal possessions, unless
it h:l.5 been deteI'lllineu that specific personal property is contraband.
The reasons for imposing any limitation and its scope must be clearly
defined, recorded and explained to you, You have the ri~ht to sell
any personal article you make and keep the proceeds from its sale.
4. You have the right to handle your personal affairs, inCluding making
contracts, holding a driver's license or professional license, marrying
or obtaining a divorce and WTiting a will.
S. You have the right to participate in the development and review of your
treatment plan.
~,lll 7B2 9-i6
.....'-.
, . .
'DATE:" ,j,JI6IG~'
, .
"
COHHONWEAL TH OF PENNSYL VAIl lA
OEPARTHENT OF CORRECTIONS
SC I-CAr'IP HILL
OOB: '-'\\1\,'\ (,,0
ooce:c NOl. ?'O
sse:' ," ,
. .. .'
"
" ,
. :~~r.:;;..',;~: .:~ ~. '.'" :", . : '<:". :- :.:~. ". .
, '."1" SUBJECT: Hcntat Health Commi.tment Summary
.0 .' . .- I
, ,
"'0_. "
........
. ,
.
TO: FfVl.~\1:. w S\I\T'\:. \'(:t....~".w,'-
:
i
ERori:',:' ,~\' c.:'~"~I~ '\\~L.
..-......
--,
"
::.
The' .above s ta ted I nma te I ~\lcl()\\() L\)(\'c,!Ll I will
be transferred from our Institution to';our facility in the
near futur.e..' The' information belo~1 provf.des a medical
summary on thl's patl,ent, pursuant to Administra'tlve 11anual,
Vo1.', oil 105.08., ' ,
1. Current Hedlcation (Including dosage and frequency):
,SI'!.l6.."tv~t(i,'o"'l 1~\O
\~~o..t'u~1l.. 'j.)\~,\'g,10
tps ~ ~ ~(."'->..vl\
.....
....
....
......
~.
.,
, .
,',
..-' -
-...'-
..-~ .,
'. .,~:~.~ ,.
. '.", ~ 00
.'. ~:
" .
2. Drug Sensitivities: a. ~C;WlV
b.
J. Special Diet Requirements: a. ~/A
b.
4. Current Illness (acute or chronic):
. o..~ '\C!. U.;)(""-\.:;~ I \.\ I v
I .
5. Injuries 'present ~t time of commitment (Include a
dcsc~iptibn of the ~reatment rendered):
6. Date' of last PPD: q\,:il\'i'\ )W\...""
Date of last DIT: ('/0) IOf.3/G'i
Ism
cc: Accompany patient (Original)
Institutional Psychiatric File
Hcntal Health Coordinator
HEr'IO-I'1i1 '
, ,
, ,
, ','OJ ........""'."',.,.'.t~a-'""':.,... ',"": ' ~','.~~..:"'."":"'7"~-,-,:;~", ~, ~<,
'-"'
(=/\:-..
l~r~L
(III) '/';'6,.;))
, ..
. -
fARVIEW STATE HOSPITAL - PREADMISSION DATA
BASE SERVICE UNIT I:
1.
PROSPECTIVE PATlENT:?,\i),\\_'V0 U"\:" I......
(41 CURRENT LOCATION: ~,. CI\1"\) \11\.l.
(b) LEGAL ADDRESS: C\,-, " ("",1., \..., \',\
RES IDrnCE COUNTY:
NEXT OF KIN (OR SIGNIFICANT OrnER):
NAME: ~ll~~"rI-\O"'~30f\)
ADDRESS: ['II-I T \,).;,'\\" \.,....0 VII
D.O,B. :
~\ \ \.... \ \"10
. ,
. L(l\;..'....,'l'n\) \'\1"'\
SENTENCING COUNTY:
(IF ANY)
~u;\\(H)li'''''\q
. ,
RELATIONSHIP:
PHONE:
"v.::!-)\ r.....
a....DD...DaD.................................................................................
2. LEGAL STATUS:
(4) MENTAL 1lEAL11I: COMM'T TYPE:
(bl CRIMINAL STATUS: CHARGED
CHARGES:__ ~\.l rl\ \c. (' "
;J .)
EI'F DATE:
CONVICTED
JUDGE: R U.)\l..>~
SENTENCED I )
SENTENCEIS) :
(INCLUDE COURT. LENGTIl OF SENTENCEIS)
SENTENCING JUDGE) \f'I(l"\'\l\"""~( 'I
, '
WITIl NAME OF SENTENCING JUDGE)
\ "If ~{,f\O() - lrt'I\~
\ \
1,['1("1
EFFECTIVE DATE:
MINIMUM: '(l,- l~-"Ill
MAXIMUM: \;::)- \ -<\~-
NO
NO
\';:\.- l-q2.,
Ie) DOES PATIENT HAVE ADVANCE DIRECTIVES?
DOES ADMISSION REQUIRE CERTIFICATE OF NEED?
YES
YES
...======..==......aAA===c===..aa.............................................................
3, PRESENTING PROBLEM:
"In",,(t\o:., 1"\:.l.;,,1':,\1"\(, I',r,":,! lI,\\l",)
,
'Ten"'ll"" ,~ \.,,",,,,I;j.c, -\'-... r f\Qt" ,,-,(2 ,..."", \X',--.....,....n\ "'j 4.~,;'I:'. ~ .I,~CI~I"'-..)
''',\<<''''''U\\ ~ In "'\,,"~ \'1,1'(. \!l'C'-1 \\.1'Jic, QQC'I""\\\V. "C. <-.J:},\ 0,..... 0."
'J: " 1 \
Q' !;:J<. ,c.:<:Q.. 'T:"'''l.>;:\c. "'C}"."'~ -".r,,,;,,' ,.,\ I(\~i)., v.,:,"\..... \4.~c..'
~ ','W < . '}" V, \ '" (\")~ cl \J[ .
~'\J\(j. 'OP'r<,,\).L)CI. "":l ""\P,G ~'1-( ..Ir 1\ .\ 'n! no.C \ "j
.............................................................................................
4, REfERRING AGENCY/PERSON: _/'-l~L\hl""" S. f1\~}L'''''''
(4) DATE & TIME OF REFERRAL: ')111'\(15 PHONE .:(111))'\1' '631
.................................................................a....a......................
11./1 l\~31
DIMllOSISI
i\( _',1\ V
~ ....~I (
,
\t.,\{j....f.
,
I
-I
i'),\{....\(lO<:) ."'J....''t'\...,...~' (\~.(."l ~...,., I.4,,",I."\.'1'\C-, "'.,d\, "V,,',,'l \. ~,'nu\' f \
.
(( hI,".)'" \>,\ol."l'\I:>lr' "Ih"!)
PSYCHOTROPIC MEDICATIOll (llICLUDE DOSAGE AND IF 1M MEDIClITIOll.
p.... I' h'II("l'\
INCLUDE DATE OF LAST SHOTI
. or.",. h,' ,""..,
,~(' I ". \.
10
I'P l\
SPECllIL CONSIDERATIONS/PREVIOUS PSYCHIlITRIC TREATMENT:
\ l.4 ,.l~(II\ h .fn'd 'j;) l ~'(l
a....aa..aa................................................................................1
FHYSIClIL CONDITION:
nry,,'~ () \.1",.. '-')
DATE TESTED FOR HIV:
\O,c\o RESULTS:
i\ ....... ~:j\"""\\' \L.,'"
DATE OF LAST PPD:
0,\ '2.9\'\'1
, .
RESULTS: NOR N ft L
DATE TESTED FOR HEPATITIS:
RESULTS:
1\101 c.,,~I).U' .,~ {', "'\
MEDICATIOll:
~Z.I' \I~'K~", (,,~q \I" ,.\""\~\?
a.a_.aDaaa....................................................................................
POST-DISCHARGE PLAN:
..........................................................=..~a==a===a==.a====.==.=..........l
DISPOSITION
A\JTIlORIZATION:
ADMISSIOll DATE:
SUBMlmD BY:
FlIRVIEW STATE HOSPITlIL
ATTENTIOll: SOCIAL SERVICES DEPARTMENT
POST OFFICE BOX *128
WlIYMART. PA 18472
TELEPHONE: (7171 488-2717 FAX I: (717) 488-2733
PA DEPT. OF CORRECTIONS
BUREAU OF DATA PROCESSING
REMOTE PRINT TIME 09:03
:NMATE RECORDS SYSTEM
CLASSIFICATION SUMMARY
.. CONFIDENTIAL ..
RUN: 'LR05PRG
DATE: 11/22/1994
PAGE .
================================================================================
:~i INITIAL__.:_i PAROLE. VIOLATOR i_: CONTINUATION :_:
,--------------------------------------------------------------------------------
" nop.,:;uMI SID' NUM : PBPP NUM: COMMITM&:NT NAME , ,INSTiCLASSIF'!
" CNO~38 : :302965 2: : LOREDO, RUDOLFO : CAM ,ll/10/:l4
---~-~~:_-----~--------~~------~-~--~~---~---~----------------------------------
. . 'I I
, '- . , '_I RACE I SEX , DTE OF BRTH
,HISPANIC : MALE : 9/16/1960
75.-----------------------------------
, HEIGHT i WEIGHT : MARITL STAT
~?2! 6 FT 1 IN , 185 LBS i SINGLE
.
... . .7.5,
90
. a___________________________________
'. ,
"
. -.
80
70
. iH 'EYES i HAIR i CITIZENSHIP
, +' .... BROWN I BROWN I UNITED STAT
. .------------------~----------------
, COMPLEXION i BUILD i RELIGION
t. ..., LIGHT I MEDIUM I CATHOLIC
.-----------------------------------
"
SOCIAL SECURITY NUMBER(S):
" 555-19-7313
60-"
... U. S. MILITARY SERVICE:
pISCHARGE: UNKNOWN
NO
i VIETNAM
, ERA: NO
PLACE OF BIRTH:
I HAVANA
CUBA'
--------------------------------------------------------------------------------
LEGAL ADDRESS: SAME
NOTIFY - NAME: RICHARD THOMPSON
ADDRESS: 917 E. COUNTY LINE
RELATIONSHIP: COUSIN PHONE:
RD LAKEWOOD
NJ
--------------------------------------------------------------------------------
MARKINGS, DEFORMITIES, TATOOS, SCARS, ETC:
PARROT ON R/FOREARM & HEART R/FOREARM, BLACK PANTHER L/FOREARM, ;-/OLFE UP R/ARM
--------------------------------------------------------------------------------
ALIAS (TN):
VILLARIN, JORGE RUDOLFO - TN
RIVERA, CARLOS - AKA
--------------------------------------------------------------------------------
P U L H EST PROBLEM ALCOHOL: NV
3 III 2 4 2 AREAS ESCAPE: NY
OTHER CONSIDERATIONS - MEDICAL LIMITS: YES
ED ACHIEVE RATING - WRAT DATE: :0/13/1994
REMARKS:
MONTGOMERY COUNTY AUTHORITIES.
DRUGS: NY SEXUAL:
SUICIDE: V
INTEL RATING: 60
READ: 9.2 SPELL:
ASSAULT: NY
PSYCHIATRIC: V
GRADE COMPED: 9
2 . 0 MATH: 2 . 0
--------------------------------------------------------------------------------
KEEP INMATE SEPARATED FROM:
--------------------------------------------------------------------------------
AFFILIATIONS (GANGS, ETC.):
UNKNOWN
lOREDO, Rudolfo
CN,0236
5. RElATIVE
NANE RElATlONSNIP ACE HARRIED EDUCAlIO. OCCUP"l ION ADDRESS
Jorge SantOI Vlllarin Father 61 Divorce 12th Cnrpentcr Ca"fornio
Hortene'. Vltl.rln Mother 58 o t vorce 9th Nur5C5 Aid HnYnnn, C\Jbn
6, RESIDENCES
from 10 ADDRESS
12/92 Prescnt Montgomery County Prison/SCI.Graterford/COCC
11/92 12/92 Norrhtown, p,t.
1989 1992 Montgomery County Prison
1984 1989 Lohwood, NJ
1982 1984 51st St end 9th ^ve, New York, NY
1980 1982 44th St and 9th Ave. New York I NY
1979 1980 NorrlstDwn, PA
1969 1979 Los Angetes, CA
1960 1969 HDvana I Cuba
7. EHPLOYHENl RECORD
Vlth Uhom Dtd You live
Incarcernted
Self
Incarcerated
friends
Self
Girlfriend
Girlfriend
fother
fomllv
Reason you Left
Re \0
from
10
Emplo er & AddresS
Type of. \lork
URge
NO SIGNIFICANT EMPLOYMENl
HIS10111.
8. SCHOOLS
.. .\;.1'...
ReDlon you'
left '
from
To
SCHOOL
ADDRESS
lost Grade you
C teted
1972
1969
1966
1976
1972
1969
King Junior High
Mitchell Torino
Los Angelclo. CA
9th
Quit
promotoll
5th
Los Angelc~. (I.
2nd -. '.- _. - 'c'. Hoved .-'
Elementary
Hovonil, Cut,.
.-....
Attorney of Record
INfORH~'IO~ SOURCES
John Hlnklns
Public: Defender
PDQ. Personal Inlcrvl.e~
"
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.:.o.~...'~o
:;..:..;. t.
'.
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DC'1B Clo.slflcotlon Summa'y
Peg, 3
LO~EDO, ~udol 10
CN'0238
C~AOES ~EPEAIED
OIHE~ CE~IlfICAIION
O~IVE~'S LICENSE
Hone
None
None
..
SCHOOL PLACEHENI
SECOHDA~Y
I.
'TrUJncy, Oehnvlor problems and luspenslons.
AC'
P'OOLEH A~EAS
ELEHENIAn-
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Regular
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EDUCAIIONAL OBJECIIVE
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~arpentry
mind hlslory,
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9. Social Data
PA~ENIAL SIAl US AI BI~IN
H'arrled
PA~ENIAL SIAIUS CHANCE
Ol\'orced
C~IIICAL INCIOENIS DU~INC LifE
Arrests, Incarceratfons and drug abuse.
fAHILY ANO HOHE CI~CUHSIAHCES
Hr. Loredo grew up in California under relatlvelv normal home and fumltv Clrcum$tances. He reports that his father provided
love, guidance, discipline end material support. Physical, emotional Dod SCAUJI abuses ore denied. At the time of hi. arrest
for the current offense, Hr. Loredo was residing In lakewood, NJ with his friend. He does not maintain contact wlth'yarlous
family members or friends. Upon release from Ihe DOC. Mr. Loredo pl~ns (0 I'csid~ in New York.
LEISU~E INIE~ESIS
Draw
IHSIIIUIIONAL ADJUSIHENI (P~EVIOUS & CU~~ENI)
198D . HOC. 4 mon(hs . Robbery. Good Adj.
1Y8S. Lake Bu(ler Slate Prison, Florida. 6 n'lOnlhs . VUfA . Harg. Adj. . I tighling misconduct whh 14 day RHU placement
1989.1992. Honlgomery County Prison. 3 years. Criminal trespass' Poor AcIJ. . Several mlsconducll for fighting and arguing
wllh multiple RHU placements . ma~lmum sentence served.
12/1/92.Present . Montgomery County Prlson/SCIC/CDCC . Current Offense' Poor Ad;. . 4 fighting misconducts while at Montgomery
County Prison with RHU ploc~ntB.
~ELICION
Religious preferenccn C'nthollc
Act 1\101
Inactlvel
( )
(,)
Classification Summary
4
LOREDO,
CN-02J6
10. OFFENSE HISTORY AND PATTERN:
Mr. Loredo reports one juvenile arrest ~nd adjudication for Theft
of a Motorcycle, for which he reportedly received probation. As
an adult, Mr. Loredo's reports combined with the rap sheet
indicates seven arrests and four convictions for the following
offenses: Robbery, VUFA, criminal Trespass and the current
offense of Burglary. Four adult commitments are evident, the
current representing his first PA state incarceration. A
detainer is noted on the inmate sentence status summary from
U.S.I.N.S. Mr. Loredo reports a walk-Off in 1960.
11. CURRENT OFFENSE:
Official Account:
No Presentence Investigation available at Classification.
Inmate's Account and Attitude:
I didn't have no money to get a ticket to go back to New York. I
went to the welfare office and they couldn't give me any money
because I didn't have an ID. I didn't know how to get the money
so I went and I broke into someone's house near-by and I got
arrested for it.
Accomplices:
None
12. MEDICAL:
Note: No kitchen, dairy or food, handling.work, while at SCIC.
No contact sports due to medical condition.
Medical Department-
13. PSYCHIATRIC HISTORY: ,(See attached)
14. PSYCHOLOGICAL REPORT: (See attached)
15.
COUNSELOR EVALUATION:
_. . .... ... ~ 1....
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Based on 'the Pennsylvania Additive Classification Tool, Mr.
Loredo is a custody level 4. Program Code "0" has been assigned ,,_.
in this case due to Mr. Loredo's history of psychiatric illness
with a past suicide attempt oy'cutting his arm. Mmr. Loredo has
also been diagnosed with Chronic Paranoid SChizophrenia and has
been on medication. Mr. Loredo presented as very, disorganiz~d.-
and tangential during his, classification interview. While.
discussing family members, Mr. Lore90 \,,'ould sudgenl:t.. b,egin ,
talking about himself, future plans to move to New York and get
a jOb as a dishwasher and past 'drug. use', '\~hen dIscussing "the
fact that he is currently past his minimum date, he would state
that he has a year to go and that if he ,did all 6 years he would
be able to go back to New York. Due to ~lr. Loredo's current-
mental health concerns, the accuracy of his reports of prior
commitments, family, etc. is questionable, however, his report in
conjunction with the rap sheet is reflected herein.
'. '
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LOREDO, Rudolfo
CN-02JB
15. COUNSELOR EVALUATION:
Con't
Pr~'s(:riptive programming includes psychiatric monitoring due to
his mental health history. SUbstance 'abuse treatment is
..'...recommended due to repor.ted abuselof Ireroin, marijuana, cocaine
.. and alcohol. ,_Basi,c remedial . ~ducation courseworK and vocational
training are suggested to aid in both i~stitutional adjustment
and employment opportunity upon eventual release from DOC.
Stress and anger management is also' suggested due to reports of
'.' several fights while incarcerated. Mr. Loredo is agreeable to
',-:, , _. substance abuse treatment. lie is 'ellgible for placement into
j. -, .~.. _ _..ge'1eral ,population at any. appropriate institution .
..
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Larry smith
corrections Counselor 2
Approved By
~ hI. /~
T moth ~. Henry
corrections C nselor supe sor
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.SENTENCE STATUS SUMMARY
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF CORRECTIONS
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,. SENTENCE SUMMARY
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Summ.ry 01 l1,ml'" on SenleJlce
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2. OATES SECTION
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DATE OF RECEPTION
9-27-94
EFFECTIVE OA TE
EXPIRA TlON OF MINIMUM
12-1-92
8-18-94
EXPIRAlIOIl OF MAXIMUM
I
I
i iHECTlVE DATE PI/
! ClELH1QUEN r TIME
12-1-98
" X X X X
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aACK W,'E
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5t:NfENr.E CHANGE
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3 REFERENCES AND IOENTIFIC.\TlON
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IJ)RECO, Hudolfo
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~ ACTIONS PENNSYLVANIA nOARD O' PAROLE
~ ACTIONS 1I0ARO or PAIIDONS
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7. SELECTIVE SERVICE SYSTEM CONTROLS
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9. NOTIFY IN EVENT OF ILLNESS OR DEATH
hi"'"
Richard Thanpson
917 E. Count'.' Line Road
Rtlll.onl"1l1 CDusin
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10. REMARKS ATA, ETC.
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LOREDO, Rodolto
CN-D23B
13. PSYCIIIATRIC IIISTORY. Hr. Loredo hos A psychiAtr1c evalUAtion at SCI-CAmp lIill on
10/24/94 because ot being treated with lIaldol And SinequAn tor Auditory hAllucinations and
throatening suicide. Dr. Robert Clark reported. "34 yeAr old CubAn male...hod been in
Norrl.otown state Hospital' about 5 or 6 times since 19B4. lIad hcera':ed hio right
antecubit~l Fosa with q razor requiring 6 outures while in the 'hole' at Hontgomery County
.'firison..... .
"Admits to IV .;'se ot cocaine.. .hot' uoe 6 year A' ago; Hao also smoked crack and hAD drunk
ao much as a fitth ot"l;. Com tort and a oi*, pack at beer in a day.. .lIever married but has
14 year old daughtor he has novor soon."
Uental status, ~4.....
Alert and oriented X 3. .Attect s/w blunted. 10 poor historian.
Speech tangential and circumstantial...teet ot judgment revealo
paranoid thinking. He~ory appears intact. Has no insight. 110
present evidence at hallucinations, delusiono, or tormal thought
dl.oorder.
Chronic Paranoid Schizophrenia, Alcohol and cocaine Dependence.
Continue treatment with antipsychotice recommended, but patient
does not want to take mede. Will D/C medo and tollow. D & II
treatment program.
. .
...
j
.: IID;r;i'aion I
. I ., . Recommendation I
. 0: '7:' ...._~~"".~....:
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--::::-. .
. 14. PSYCHOLOGICAL REPORT.
Telt Admini.tered. All testo were administered on 10/13/94.
Revised Beta II Examination (RBE)
Jastak Wide Range Achievement Test (WHAT)
Reading score.
Spelling Score.
Arithmetic Score.
42
23
23
st.Sc. 88
St.Sc. 59
st.Sc. 53
\lle' 21
\ile. ;7
\lle' .1
G.E.
G.E.
G.E.
9.2
2
2
Bender Hotor Gestalt' (BHG)
Projective Drawings (HTP)
Analvsis of Intelliqence and Intellectual Function!nQI
Hr. Loredo earned a Beta Quotient of <60. Thio ecore falls within the Hentally Deficient
range ot mentai ability according to the Beta II claesification. The obtained rating i.
not viewed as a reasonably accurate estimate of his intellectual potential. Based on
observed, objective behavior meaoures, including WHAT 3 Reading standard scoreo and
clinical interview impressions, Hr. Loredo appears to be functioning at leaot within the
Borderline range of intelligenco.
Analvsis of Personality MakeuPI
Hr. Lorodo'o teot reoponoee and intorview ouggeoted an impulsive, oppositional, suopicious
individual with a chronic subetanco abuse problem, He further seemo to be oubject to
depresoive difficultieo, poor reality orientation, and ouicidal behavior under otreos.
Hr. Loredo prosented as a poor historian. he seemed confuaed, poorly-organized, and
poorly-controlled. Although he denied eituational psychological difficutties, thio man
seemed to have poor self-appraisal skills and insight. lie looked depressed, was poorly
groomed, and soemod out of touch with hiD deepeot emotions. In addition, Hr. Loredo is
facing the streos of dealing with a serious illness. His projective drawings suggested
dependency and insecurity, oppositionality, and the likelihood of a blunt, ag9resoive
response set - especially under etress.
Hr. Loredo is recommended for oubstance abuse treatment and continuing poychiatric
monitoring. lie also needs poychological counseling to addrees his depreoeion, to improve
impulse control, and to improve his coping skillo for managing the etreoe of his current
medical diagnoois. Extremely close supervioion io advised for this inmate because at his
hiotory of suicidal behavior. lie ohould be watched carefully and referred to mental
hsalth personnel if any oigns of emotional decompensation arc noted.
Hargaret lie 1m
Psychological serviceo Speciallst
Idkm
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CDCC.INDIVIDUAL TR~TMENT ~LAN
. CONFIDENTIAL TO DE PLACED
IN PSYCHIATRIC FILE MEDICAL RECORDS
N1\ME: Loietbo, r2UT;x;l-rO NUMBER: CNOZJ,f"DATE: /0/2';1/91.(._
CURRENT DIAGNOSIS: . GBMI YES NO 0./
. (J1!r:..u;..) ,c. /)1t~(+N~ t l':::l Self I ;L.O Ptf!GENtA
~SYCll HEDS: ('JONe - DOES Nor w/i-fJ r HcbS I
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HOSPITALIZATION: /J()(2.(Lt S rON N Si7l re - S1h.~)< S//VCE: 17.r]l
SOICIDAL: -;J. Il-rTC-+lP is ,+r N S H - CU r Illm~C/.)f3IT1/t.. FO~Urc- of-NcCf<
:,i).:'+:.:i/S::)>>......RBco!iHiNDBD.TRElATHENT SERVICES;': '..,'. ...........>.;;. .....
SEX on. D. ABUSE V
COONSL. OTHER: 'P'0l(;.HfIHP-IC. 'FOl.L()IA.'"
ALC. ABOSE ./ UP, r (2.. T 1-15(.
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SAT DISCON. / NAME
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REC. INST.'
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PSYCHOLOGIST
.\
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PSYCllIJ\TRISlr t.,,'-(i(.c.-{ {j!t<...u'!.-, DO
-
10
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ATTACHMENT B
SCl-Camp Hill
GATE CLEARANCE
DATE: 'd.lJ.Ql9 ~
SUBJECT:
SCl-Camp Hill, Gate Clearance
TO:
Main Gate, Rear Gate, Guest House
--
FROM: Anthony L. petruccio
Deputy Superintendent
for Centralized Services
The following individual(s) are authorized to enter/exit the institution via the
Main Gate, Rear Gate, Guest House:
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Time: \ ',<10 Cl M
Date:~\q5
\-..I/"\h~~ ~ <1....1'rl'V1 ~Q
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Rationale for Gate Clearance:
?-011
Q~.ll,
~\\ (} '?\).I"!' '-l.n.~l a r-llt-
~ CVO~ 'Sf'l('Ko.<',t
Contact staff member when the individual(s) arrive:
~ fl'\~ - 4'131
Approval:
Department Head Review
Signature
-.
cc: Superintendent Beard
Deputy Kyler
Control Desk
Captains Office
Main Gate
Rear Oa'te ,
Guest house
1"'"
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\...0C' 'GOi./
u-\ \:)L33
BILL OF RIQITS
, YOU HAVE A RIG}fT TO BE TREATED
, l(l11l DIGUn AND RESPECT
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-;N'\\IJI.
YOU SHALL RETAIN ALL CIVIL RIGHTS ~~T
HAVE NOT BEEN SPECIFICALLY CURTAILED BY
ORDER OF COURT
. '.
1. You have the right to unrestricted 'and priv~te communication inside
and .outside this facility including the fOllowing rights:
.
a. To peaceful assembly and to join with other'patients
to organize a body of or participate in patient
goveI1U:lent when patient government has been deter.:Ul1ed
to be feasible by the facility,
b.
To be assisted by any advocate of your choice in the
assertion of your rights and to see a lawyer in private
at any time.
'. .
c. To make complaints and to have your complaints heard
and adjudicated promptly.
, .
d. To receive visitors of your own choice at reasonable
hours unless your treatment teae has dete~ined in
advance that a visitor or visitors ~ould seriously
interfere with your or others treatment or welfare,
.-_.
e. To receive and send unopened letters and to have out-
going letters sta:nped and c.tiled. Incoming mail may
be examined for good reason in your presence, for
contraband. Contraband means specific property which
entails a threat to your health and welfare or to the
hospital co~ity,
1..1
,-
. . f. To have access to telephones designated for patient use.
::;-
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You have the right to practice the religion of your choice or
to abstain from religious practices,
3.
You have the right to keep and to use personal possessions, unless
it has been determined that specific personal property is contraband.
The reasons for imposing any limitation and its scope mUst be clearly
defined, recorded and explained to you. You have the ri~ht to sell
any personal article you make and keep the proceeds from its sale.
4.
You have the right to handle your personal affairs, including making
contracts, holding a driver's license or professional license, ~rrying
or obtaining a divorce and ~Titing a will,
S. You have the right to participate in the development and review of your
treatment plan.
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