Chapter 5 – Adult Custody and Security Operations

52050.23.4 Mechanical Restraints

• The inmate shall be placed in handcuffs attached to a waist chain while on CSW. Leg restraints may be used in cases where custody staff determines the inmate poses a threat to the safety of himself and/or others, in accordance with CCRCalifornia Code of Regulations, Title 15, Section 3268.2 Use of Restraints.

• Use of mechanical restraints on persons confirmed, or suspected by health care staff to be pregnant shall be subject to the following requirements (see also CCRCalifornia Code of Regulations, Title 15, Section 3268.2(e)):

  • No leg restraints or waist chains shall be applied.

  • If handcuffs are applied, the person’s arms shall be brought to the front of her body for application.

• Mechanical restraints shall not be placed on an inmate during labor, including during transport to a hospital, during delivery, and while in recovery after giving birth, unless circumstances exist that require the immediate application of mechanical restraints to avoid the imminent threat of death, escape, or great bodily injury. If such a threat exists, mechanical restraints may be used only for the period during which such threat exists (see CCRCalifornia Code of Regulations, Title 15, Section 3268.2(c)(5)). Four point restraints may be authorized when an inmate is disruptive or combative in accordance with CCRCalifornia Code of Regulations, Title 15, Section 3268.2 (c), and when approved by the Chief Medical Executive (CME) or their designee. The use of four-point restraint equipment shall be documented in the inmate’s Uniform Health Record (UHR) in accordance with CCRCalifornia Code of Regulations, Title 15, Section 3268.2(f).

• Hand Isolation Devices (HID) may be used at an institution when authorized, in writing, by the Warden or CDW. HIDs shall be purchased from an approved vendor only. Prior to placing a HID on an inmate confirmed, or suspected by health care staff to be pregnant, a physician shall be consulted and any potential risks fully discussed. The final decision to place the device on the inmate shall rest with the Warden or CDW and the reviewing physician. The consultation and its outcome shall be documented for inclusion in the inmate’s health care record and central file. Inmates placed in a HID shall remain under constant and direct visual supervision at all times. In instances where a HID is used, staff shall update the inmate’s CDC Form 114A to reflect usage times and correlating actions (e.g., 1200 hrs – One HID was removed allowing the inmate to eat lunch). Equipment Hygiene – HIDs shall be cleaned and sanitized on an ongoing basis (e.g., If soiled after a bowel movement, after termination of the CSW, etc.). In order to provide range of motion to a restrained extremity, a CSW inmate should be allowed free movement of each arm and leg at least once on 2nd and 3rd watch. Each restrained extremity should be released for a free movement period of at least 5 minutes on 2nd and 3rd watch. As appropriate to the situation, only one extremity need be released at a time. The application of additional restraints (e.g., Leg Irons, HID, etc.) other than handcuffs and waist chain shall be documented on the inmate’s CDC Form 114A.