SIERRA CONSERVATION CENTER



SIERRA CONSERVATION CENTER

JAMESTOWN, CALIFORNIA

REQUEST FOR SECURITY CLEARANCE

|A GATE CLEARANCE is required on any person entering the prison’s security area. Before admittance, a security clearance is required on all individuals. Once |

|obtained, a security clearance is valid for no more than one year from the date of CI&I. To complete a security clearance, the information below must be provided. |

|Any omissions may result in denial of visiting Sierra Conservation Center. |

| |

|** PLEASE READ AND SIGN BOTH FRONT AND BACK OF FORM ** |

|VISITOR NAME (PRINT): |Attorney/Legal Visit: |

| |Put Inmate name, CDC # in comment section |

|GENDER | | |ETHNIC | WHI | HISP | ASIAN |

| MALE | FEMALE | | | BLK | AMI | OTH___________________________ |

|VISITOR OR BUSINESS/AGENCY ADDRESS AND PHONE NUMBER: |

| |

| |

|DATE OF BIRTH |SOCIAL SECURITY # or STATE BAR # |DRIVERS LICENSE # & STATE |

|PURPOSE OF VISIT: | ONE DAY VISIT on ______________ |

| | |

| |VARIOUS DATES |

|HAVE YOU EVER BEEN ARRESTED? YES NO If yes explain in comments below |

|HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO If yes explain in comments below |

| |

|COMMENTS: |

| |

| |

|VISITOR SIGNATURE: |DATE |

|DEPA| |REQUESTING EMPLOYEE NAME AND TITLE (PRINT): |REQUESTING EMPLOYEE SIGNATURE: |

|RTME| | | |

|NT | |M. D. Steele, Litigations Coordinator | |

|USE | | | |

|ONLY| | | |

| | |REQUESTING EMPLOYEE DEPARTMENT: |PHONE EXT.: |DATE: |NEW CI&I |

| | | |5365 | |CI&I RENEWAL |

| | |SCC-Litigation Coordinator | | | |

| | | | | |

| | |Custody Captain: |APPROVED: YES NO |DATE: |

| | | | | |

| | |Associate Warden, Central Division |APPROVED: YES NO |DATE: |

| | | | | |

| | |Warden (if applicable): |APPROVED: YES NO |DATE: |

| | | | | | |

| | |CI&I APPROVAL BY: |

| | | |

| | | |

| | |CORRECTIONAL CASE RECORDS MANAGER |

| | |DATE:_____________________ |

| | | |

| | |FOYER USE ONLY |

INPUT DATE: |

INPUT BY: (Initials) | | EXP. DATE (not to exceed one year):

| |

BACK OF ATTACHEMENT 1

Listed below are outlined rules and regulations governing the behavior of visitors and guest of the

Sierra Conservation Center, Jamestown, California. The California Penal Code provides the following:

Section 4534: Any person who helps a prisoner escape or attempt to escape shall be imprisoned not more than ten years and may be fined not more than $10,000.00.

Section 4545: Any person who carries into a State Prison anything useful to help a prisoner escape shall be imprisoned for one year to life.

Section 4570: Any person who communicates with any prisoner, or gives to him, or takes from him, any letter, writing or reading matter, without prior permission is guilty of a misdemeanor, and is subject to a sentence of six months and a fine of $5,000.00

Section 4571: Any inmate of a California State Prison who comes on-grounds of any prison without permission of the person in charge may be imprisoned for not more than five years.

Section 4573, 4573.5 and 4573.6: Any person who brings into prison any drugs, tobacco or alcoholic beverage without the specific authorization of the proper officials is subject to a sentence of six months to five years.

Section 4574: Any person who brings firearms, deadly weapons, or explosives, into any prison may be imprisoned for two, three, or four years.

Section 4567: Any person who brings any cellular device or other wireless communication with the intent to deliver, or delivers, to an inmate is subject to a sentence of six months and/or a fine not to exceed five thousand dollars for each device.

The Department of Corrections Rehabilitation Manual, Chapter 3, Article 11, Smoking/Non-Smoking and Tobacco Prohibition states that smoking is prohibited on state property. All tobacco products must remain in vehicles while on state property.

RULES CONCERNING VISITORS:

Trading or bartering on the part of the visitor with inmates is forbidden. Visitors must not give to or receive anything from an inmate without the prior approval of the office in charge. Visitors shall not indulge in familiarity with inmates nor shall they permit any familiarity on the part of inmates toward themselves. No visitor may come upon the grounds of the institution if he/she appears to have been using intoxicants or drugs. .

No tips, gifts or reward of any kind shall be given or promised to any inmate for any reason. No inmate shall ask for or accept a gift or favor from any visitor, nor shall be given a gift or a promise of one.

IN ADDITION TO THE RULES AND REGULATIONS ABOVE PLEASE BE ADVISED OF THE FOLLOWING:

All outside guest must be previously cleared through the Warden in advance of visiting the institution. The Custody Captain’s Office maintains a log of all person(s) that are approved or disapproved.

Visitors must understand that the California Department of Corrections & Rehabilitation does not recognize hostages for bargaining purposes.

No male or female visitor wearing blue jeans or chambray (blue denim) shirts will be allowed into the institution.

If currently on parole, you must submit written approval from your parole or probation officer before approval is granted to visit Sierra Conservation Center.

_________________________________________ _________________________

VISITOR’S SIGNATURE DATE

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CONFIDENTIAL

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