Robert A. Barton
Inspector General

Office of the Inspector General

2015
Special Review:
High Desert State Prison
Susanville, CA

December 2015

Office of the Inspector General
2015 Special Review:
High Desert State Prison
Robert A. Barton
Inspector General
Roy W. Wesley
Chief Deputy Inspector General

10111 Old Placerville Road, Suite 110
Sacramento, CA 95827
Telephone: 916-255-1102
Facsimile: 916-255-1403

December 2015

Table of Contents
FOREWORD ....................................................................................................................... i
Scope, Methodology, and Objective ........................................................................... i
Summary of Findings ................................................................................................. ii
BACKGROUND ................................................................................................................ 1
High Desert State Prison ............................................................................................ 1
Media Attention, Legislative Scrutiny, and Past OIG Reports .................................. 3
ENTRENCHED CULTURE .............................................................................................. 7
Remote Location ........................................................................................................ 7
The Susanville “Car” Mentality and Code of Silence ............................................... 9
Peer Review ............................................................................................................... 9
Racism and Implicit Bias ......................................................................................... 11
The Need For Increased Inmate Programming and Staff Resiliency Training ........ 13
The California Correctional Peace Officers Association ......................................... 15
Recommendations to CDCR .................................................................................... 17
SEX OFFENDERS AND THE R SUFFIX ...................................................................... 19
R Suffix .................................................................................................................... 19
SOMS Access .......................................................................................................... 20
Recommendations to CDCR .................................................................................... 21
SENSITIVE NEEDS YARDS .......................................................................................... 22
Recommendations to CDCR .................................................................................... 26
INMATE APPEALS AND STAFF COMPLAINTS ....................................................... 27
Appeal Collection and Processing ........................................................................... 27
Volume of Appeals at HDSP ................................................................................... 28
Staff Complaints ...................................................................................................... 29
Disincentives to Filing Staff Complaints ................................................................. 31
Recommendations to CDCR .................................................................................... 32
USE OF FORCE INCIDENTS ......................................................................................... 34
HDSP Use of Force Frequency ................................................................................ 34
The Need For Cameras in All Inmate Areas ............................................................ 36
The Need to Pilot a Program Using Body Cameras ................................................ 37
Allegations That Staff Are Slow to Respond to Incidents ....................................... 38
Recommendations to CDCR .................................................................................... 39

ARMSTRONG REMEDIAL PLAN–ADA INMATES..................................................... 40
Disability Placement Program ................................................................................. 40
Callous Treatment of DPP Inmates.......................................................................... 41
Internal Compliance Reviews and Plaintiff Tours ................................................... 42
Recommendations to CDCR .................................................................................... 47
INTERNAL AFFAIRS INVESTIGATIONS ................................................................... 48
Hiring Authority Referrals and Internal Allegation Inquiries.................................. 48
Allegations of Misconduct Involving HDSP Staff .................................................. 49
Office of Internal Affairs Resident Agents .............................................................. 53
Recommendations To CDCR .................................................................................. 54
FINDINGS AND RECOMMENDATIONS..................................................................... 55
CONCLUSION ................................................................................................................. 61
APPENDICES .................................................................................................................. 63
Appendix A–Senate Rules Committee Authorization Letter…………………..…..64
Appendix B–CDCR Memorandum: Enhanced Program Facility Institutions….….66
Appendix C–CDCR Memorandum: Secure Appeal Collection Sites and Related
Matters...................................................................................................................69
Appendix D–CDCR Zero Tolerance Regarding the Code of Silence………..…...71
Appendix E‒Peer Review‒High Desert State Prison……………………...………72
Appendix F‒Police Racial Violence: Lessons From Social Psychology……….....89
Appendix G‒Center for Mindfulness in Corrections……………….………...….105
Appendix H‒Average Number of Incidents per 100 Inmates, June 2014-June
2015…………………………………………….……….…………107
Appendix I‒Average Number of Inmate Disciplinary Actions per 100 Inmates June
2014-June 2015 ..………...…..……….………………………………….......108
Appendix J‒WCI Taser Body Camera Pilot………………………………......………….109

FOREWORD
On June 25, 2015, the Office of the Inspector General (OIG) received a request and
authorization 1 from the Senate Committee on Rules, to review the practices at High
Desert State Prison (HDSP) in Susanville, California, with respect to:
1.
2.
3.
4.

Excessive use of force against inmates,
Internal reviews of incidents involving excessive use of force against inmates,
Protection of inmates from assault and harm by others, and
Armstrong class inmates. 2

In its request, the Senate Committee reported that a number of allegations surfaced that
raised concerns about the safety of both inmates and staff. As part of this review, the OIG
requested the California Department of Corrections and Rehabilitation’s (CDCR or the
department) Office of Internal Affairs (OIA) immediately open expedited investigations
into each allegation; the OIG is monitoring these investigations. The incidents are
discussed later in this report. In addition to these specific incidents, the Senate Committee
noted that there have also been general allegations asserted that some members of
custody staff at HDSP refer to inmates as “sodomites” or “sex offenders” in the presence
of other inmates and disclose inmates’ commitment offenses, placing inmates at risk of
harm from other inmates.
Ultimately, this review is intended to determine whether there is a culture among the
custody staff at HDSP that contradicts the CDCR’s paramount objective of ensuring the
safety of both inmates and staff in the prison system.

S COPE , M ETHODO LOGY ,

AND

O BJECTIVE

The scope of this special review encompasses the areas of the Senate Committee on
Rules’ request described above, along with the statutory mandate of Penal Code (PC)
Section 6126, which requires the OIG to identify areas of full and partial compliance, or
noncompliance, with departmental policies and procedures, specify deficiencies in the
completion and documentation of processes, and recommend corrective actions,
including, but not limited to, additional training, additional policies, or changes in policy,
as well as any other findings or recommendations deemed appropriate.
During the course of its review, the OIG examined applicable laws, policies, and
procedures; revisited past reports and media accounts; interviewed staff and inmates
formerly assigned to HDSP; reviewed complaints filed by former HDSP staff and
deposition testimony from the Jones v. Cate litigation; reviewed inmate appeals,
disciplinary actions, confidential inmate files, and complaints against staff; reviewed
misconduct allegation inquiry reports, internal affairs investigation reports, and death
review reports; and actively monitored 20 misconduct investigations involving HDSP
staff.
1
2

A copy of the authorization can be found in Appendix A.
The Armstrong class action lawsuit is discussed in detail on page 40 of this report.

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S UMMARY

OF

F INDINGS

There is evidence that a perception of insularity and indifference to inmates exists at High
Desert State Prison, exacerbated by the unique geographical isolation, the high stress
environment, and a labor organization that opposes oversight to the point of actively
discouraging members from coming forward with information that could in any way
adversely affect another officer. These aspects coupled with the difficult missions at
HDSP have helped create an entrenched culture of self-protection and loyalty to HDSP
above everything else.
Accounts from both staff and inmates depict a culture of indifference perpetuated by at
least some staff. Reports from inmates of appeals being read and destroyed and officers
using profane and derogatory language directed at inmates were corroborated by at least
some staff.
The conflicting missions at HDSP make it difficult for vulnerable inmates, whether by
commitment offense or disability, to program safely. Hardline officers run some yards
with little regard for vulnerable inmates. The most extreme example is the Level IV
sensitive needs yard (SNY) facility, which is just as violent as the general
population (GP) yards, with gang politics meting out abuse and punishment for drug and
gambling debts and extorting vulnerable inmates for protection, all of which is
exacerbated by the tacit acquiescence of custody staff.
The department’s use of the R suffix to designate the restricted custody of certain inmates
has served as a bull’s-eye target at HDSP and other prisons, most notably on SNY yards.
Based upon this review and observations in prior OIG reports, the continued use of
sensitive needs yards merits a complete overhaul.
The inmate appeals system at HDSP is not functioning adequately and the staff complaint
process is broken. Very few staff complaints were referred for investigation and those
that were referred have not been adequately monitored and tracked for response. Also,
HDSP does not have a process for addressing officers who are repeatedly accused of
misconduct by different inmates. There are statistical trends, continued complaints, and
recent misconduct allegations that cause alarm about the use of force at HDSP.
Finally, the OIG found that the use of resident agents by the Office of Internal Affairs is a
poor practice, and should be discontinued, especially at HDSP in light of the issues that
arose from the placement of a resident agent at that institution. Additionally, the
processes in place for allegation inquiries at HDSP are inadequate, and could be
improved statewide. The OIG is monitoring several misconduct investigations that, but
for this review, may not have been opened or investigated to the broadest extent
appropriate. Because the investigations have not been completed, only the general facts
are discussed in this report, but results will be published in a future OIG Semi-Annual
Report. The OIG made 7 broad findings and 45 specific recommendations during this
review (see pages 55 to 60 for a detailed list).
--- ROBERT A. BARTON, INSPECTOR GENERAL
2015 Special Review: High Desert State Prison
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State of California

BACKGROUND
H IGH D ESERT S TATE P RI SON
In 1995, the department activated High Desert State Prison adjacent to the grounds of the
California Correctional Center (CCC), in Susanville, CA. Since its activation 20 years
ago, HDSP has undergone continuing changes to its mission, and today each facility
houses a population uniquely different from the adjacent yards. According to CDCR’s
website, the primary mission of HDSP is to provide for the housing 3 and programming of
general population and sensitive needs high security (Level IV) and sensitive needs
medium security (Level III) inmates. The inmate population consists of three Level IV
yards, two of which are 180-degree design buildings (Facility C and Facility D), and one
270 design building (Facility B). Facility B was converted to a sensitive needs yard in
October 2007, which houses Level IV SNY inmates.
HDSP
Facility
A
B
C
D
E
Z

Housing
Type

Custody
Level

Number of Housing
Unit Buildings

SNY
Reentry Hub
SNY
EPF
GP
ASU
MSF
ASU

III
III
IV
IV
IV
III/IV
I
III/IV

4
1
5
8
7
1
2
1

In mid-2015, Facility A was converted from a Level III general population yard to a
Level III sensitive needs yard. The stated purpose of the conversion was to: 1) assist the
department in reducing the number of Level III GP vacancies and reduce current Level
III SNY overcrowding; 2) further allow increased Reception Centers (RC) inmate
movement, and mitigate potential inmate backlogs in the RC, which impede CDCR's
ability to accommodate weekly county intake; and 3) assist in efforts to meet the Level
III SNY crowding standard, as outlined in The Future of California Corrections
Blueprint. Facility A is also the home of the Reentry Hub Facility, which has the goal of
providing relevant training and services to eligible and interested inmates in order to
facilitate the successful transition back to their communities and reduce their likelihood
of reoffending.
3

An inmate’s classification determines the type of housing in which he will be placed. Level I or II inmates
may be housed in open dormitory settings. Level III and IV inmates are placed in 180-degree design or 270
celled housing units. The number of degrees refers to view from a central elevated control booth. The “180degree” design is a configuration of the cellblocks (housing units). The cellblocks are partitioned into three
separate, self-contained sections, forming a half circle (180 degrees). The partitioning of sections, blocks,
and facilities ensures maximum control of movement and quick isolation of disruptive incidents, thereby
ensuring effective overall management of inmates.

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On January 1, 2014, Facility C became the location of one of CDCR’s seven enhanced
program facilities (EPF). According to CDCR’s EPF activation memo, 4 EPFs are
designed to “offer incentives for inmates who, based on their own behaviors and choices,
are ready to take full advantage of programming opportunities.” The EPFs are designed
to provide programs and privileges not readily available on other yards, such as advanced
college degree programs, increased canteen draw, and an expanded property allowance,
with the goal to incentivize and reinforce positive behavior. While HDSP Facility C has
been designated an EPF for nearly two years, it appears to be an EPF in name only, as
staff estimate that 95 percent of the inmates in the EPF do not meet the criteria, and are
only placed there because they meet the general Level IV housing criteria, with no enemy
concerns, and not because they voiced a desire to participate in enhanced programming.
HDSP’s Facility E is the minimum support facility (MSF), which houses non-camp
eligible Level I inmates who perform job duties in various areas of the institution outside
the secure perimeter.
The Administrative Segregation Unit (ASU) was originally located on Facility D, a 180design housing unit, and consisted of two buildings, D7 and D8. Within the first three
years of HDSP’s activation, it became apparent that the building originally designed and
designated as the ASU was not adequate to meet the demands of the inmate population
who require segregated housing. Construction on a new stand-alone ASU began in
October 2001. The new unit was named Facility Z and activated in September 2004, but
buildings D7 and D8 continued to also serve as ASU beds, until just recently, when
building D7 reverted back to GP housing.
Finally, while this area is addressed in depth later in this report, it should be noted that
HDSP has been a designated Disability Placement Program (DPP) institution since at
least 1997. This means that inmates with verified disabilities impacting their placement
(such as wheelchair users or inmates with impairments to their mobility, vision, hearing,
or speech) can be housed at HDSP, with the expectation that these inmates will be
provided access to programs and services, with reasonable accommodation when
required. The requirements of the DPP are laid out in the Armstrong court-ordered
remedial plan. Armstrong is a class action lawsuit brought under the Americans with
Disabilities Act (ADA) and the Rehabilitation Act in 1994, on behalf of inmates and
parolees with disabilities.
No two yards at HDSP have the same mission. According to CDCR, the design capacity
for housing inmates at HDSP is 2,324 with a staffed capacity of 3,461. 5 While the actual
number of inmates housed at the prison changes daily, the total number of inmates
housed at HDSP on November 30, 2015, was 3,482, or 149.8 percent of its design
capacity.

4

A copy of the EPF memo can be found in Appendix B.
http://www.cdcr.ca.gov/Reports_Research/Offender_Information_Services_Branch/Monthly/TPOP1A/TP
OP1Ad1511.pdf
5

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In the last eight years, HDSP has had six different wardens or acting wardens. Suzanne
Peery was the acting warden at HDSP from February 2, 2015, until December 1, 2015.
Peery has spent her entire corrections career in Susanville, starting at CCC in 1988 before
transferring to HDSP in 2006 as the employee relations officer, and ultimately working
her way up to Chief Deputy Warden before being named acting warden.
Adjacent to HDSP is the California Correctional Center, which houses approximately
2,196 inmates with responsibility for an additional 1,726 inmates assigned to fire camps,
giving it a total population of 3,922 inmates. It is also worth noting that located 37 miles
south of Susanville is Federal Correctional Institution, Herlong, a medium security
federal correctional institution with an adjacent minimum security satellite camp, which
houses approximately 1,445 male offenders.

M EDIA A TTENTIO N , L EGISLATIVE S CRUTINY ,
R EPORTS

AND

P AST OIG

2007 PBS documentary: Prison Town, USA
Susanville was the subject of a 2007 PBS documentary titled Prison Town, USA.
The program focused on the prison building boom and the common practice of siting
prisons in rural towns, due to the “NIMBY” (Not In My Back Yard) policies of large
metropolitan cities, coupled with the desire of city officials to generate jobs in rural
communities that have suffered an economic downturn due to the closure of anchor
employers such as sawmills. The program examined the impact of building HDSP in a
town that already had a State prison and a federal prison. The program followed the lives
of specific officers (some of whom still work at a Susanville prison) and their families
over the course of two years. According to the PBS website:
The resulting story is one of hard choices and unanticipated consequences.
As Susanville's good-hearted country-boys-turned-prison-guards soon learn, life
outside the walls is developing eerie parallels to life on the inside. At the
correctional officer training academy, officers have to learn new skills and
attitudes, often quite foreign to their upbringing. Besides the obvious dangers of
the job, the constant tension spills into the [officers’] home lives, changing how
they relate to their families and friends. In a sense they, too, are imprisoned — a
reality that is hard to shake once they leave work.
According to the documentary’s co-director, Katie Galloway, one reason for making the
film was: "We hope this film will awaken people to the real consequences of prison
expansion, particularly in rural areas that have been so important in forming the history
and character of California and the country."
July 2008 Evaluation of the Behavior Modification Unit Pilot Program at High
Desert State Prison, Conducted by CDCR’s Adult Research Branch
In July 2008, the department published an evaluation report of its Behavior Modification
Unit (BMU) Pilot Program, which was implemented at HDSP on November 21, 2005.
This program was developed and implemented to respond to disruptive inmate behavior
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that was not serious enough to warrant ASU or Security Housing Unit (SHU) placement,
but was disruptive to the general population. The report contained inmate interviews and
stated that some of the accounts were rather typical inmate complaints, while others were
serious allegations of mistreatment, such as inmates (some clad only in socks and boxer
briefs) forced to stand outside in the snow for over two hours. Recurring themes included
racism, retaliation for filing appeals, and officers provoking physical altercations.
May 2010 Sacramento Bee articles, written by Charles Piller, titled: “Guards
accused of cruelty, racism” and “California prison behavior units aim to control
troublesome inmates”
The headline for a two part series in the Sacramento Bee described the report as an
“investigation into the behavior units at High Desert State Prison, including signed
affidavits, conversations and correspondence with 18 inmates … [which] uncovered
evidence of racism and cruelty at the Susanville facility.”
December 2010 California State Senate Review of the BMU at HDSP
After the publication of the Sacramento Bee articles referenced above, staff working on
behalf of the California State Senate reviewed hundreds of documents and conducted
numerous interviews to better understand and assess the allegations referenced in the
article. The Senate cited the need for improvement in the department's system of
accountability to ensure that allegations of abuse and misconduct in correctional
institutions are addressed swiftly, systematically, and fairly for all involved. The Senate's
review of the circumstances that gave rise to the public scrutiny of conditions at the BMU
at HDSP highlighted the importance of making sure that the department's methods for
handling reports of inmate abuse or staff misconduct are performing well. The review
stated, “Every means by which the department receives information about prison
conditions - whether formal or informal, or from an inmate, employee or member of the
public is a valuable opportunity for the department to ensure the integrity of its
operations. Every observer ought to be regarded as an asset, and every supervisor ought
to be empowered as a portal through which information about prison conditions will be
shared, evaluated, investigated and addressed.” The Senate’s review of the BMU
allegations suggested that the department would be well served by a recalibration of how
it handles complaint allegations, from intake through investigation and resolution.
September 2011 OIG Special Report: CDCR’s Revised Inmate Appeal Process
Leaves Key Problems Unaddressed 6
In January 2011, CDCR revised its inmate appeal process. One of the primary
deficiencies CDCR identified in its appeals process was that appeals are not logged until
they reach the Appeals Office and appeals do not have a receipt feature, leading to
system-wide allegations that appeals were destroyed or lost, either intentionally or
negligently.

6

OIG reports can be accessed at www.oig.ca.gov

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CDCR’s revised process redirects the inmate to the written “request for interview”
process, which does require a copy be given to the inmate; however, this report found
that if the inmate bypasses this process or elevates the issue to the formal appeal level,
there is still no receipt feature.

As a consequence, CDCR’s appeal process still does not address inmate allegations that
appeals are routinely discarded or read by custody staff and then destroyed if they contain
accusations of misconduct.
In response to this report, the department issued a December 30, 2011, directive 7 to all
institutions, which, among other mandates, prohibited the reading or inspecting of
appeals by anyone other than Appeals Office staff, and required the installation of secure
appeals lock boxes in the housing units, retrieval from which shall only be done by
Appeals Office staff and/or staff designated by the warden.
October 2011 OIG Special Review
Between November 8, 2010, and June 16, 2011, the OIG conducted a review of
allegations that HDSP staff violated the civil rights of inmates housed in Facility Z, often
referred to as “Z Unit,” the institution’s stand-alone ASU. After reviewing a dozen
different categories of alleged abuses, the OIG determined most of the allegations to be
unfounded, but discovered concerns with inconsistent laundry exchange practices, a lack
of policy direction regarding cold weather searches, inadequate law library access, and
failure to provide the required ten hours of exercise yard time per week.
May 2012 OIG Special Review: High Desert State Prison
As a result of repeated complaints regarding HDSP staff, the Senate Committee requested
the OIG conduct a special review to determine whether staff intentionally or negligently
allowed inmates to identify sex offender inmates, thereby subjecting inmates to potential
7

A copy of the directive can be found in Appendix C.

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harm. Although the review did not result in enough corroboration to pursue all inmate
allegations, the volume and relative consistency among the inmate complaints gave
credence to the existence of a problem within the Level IV SNY facility at HDSP. The
pervasive complaints and incidents revealed should have at least alerted the department
and caused some action to make sure such practices were not occurring. However, it
appears that no action was taken. It was evident from the number of inmate victims and
assailants making allegations of officer misconduct that there was a culture of hostility
toward sex offender inmates at HDSP. In addition, some of the officers interviewed at the
time indicated that they believed there were officers at HDSP who would provoke
inmates into physical altercations to necessitate the use of force. This raised a concern
regarding a culture of abuse and code of silence at HDSP, and some of the inmates
interviewed believed that they would be retaliated against just for talking to the OIG or
CDCR’s Office of Internal Affairs.
August 30, 2015 BuzzFeed News article written by Albert Samaha, titled: The Job
Made Me Do It. The Prison Guard Who Couldn’t Escape Prison, Scott Jones loved
being a correctional officer at California’s High Desert State Prison. Then he saw his
colleagues commit enough abuses that he saw no choice but to break the code of
silence, turning himself into a pariah in a neighborhood called C/O Row.
The BuzzFeed article chronicles the events leading up to an officer’s suicide, after he
“broke what one former prison guard called ‘the green wall of silence’ — the code of
silence that has turned California’s state prisons into insular and isolated facilities of
unconstitutional conditions, where what happens on the Inside stays on the Inside. It is an
unwritten rule meant to protect the men and women tasked with overseeing the state’s
130,000 inmates, and Scott had to pay for violating it."
August 31, 2015 Rolling Stone Magazine article written by Jessica Pishko, titled:
High Desert Suicide: Was a Prison Guard Hazed to Death? At one of the country's
most dangerous prisons, correctional officers face off against murderers, rapists,
gangsters and each other.
The Rolling Stone article explores the events leading up to the 2011 suicide of a High
Desert State Prison correctional officer (one of five staff suicides since 2008, according
to the article).
None of these prior articles or reviews has had the desired impact of permanently
improving HDSP. Instead, they were mere harbingers of continued problems that still
exist.

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ENTRENCHED CULTURE
R EMOTE L OCATIO N
Susanville is located in Lassen County, a remote location in rural northeast California.
Susanville is located 86 miles from Reno, Nevada; 112 miles from Redding, California;
and 106 miles from Red Bluff, California. The 2014 census population estimate for
Susanville was 15,543. HDSP and CCC employ 953 and 871 staff, respectively, making
them the largest employers in all of Lassen County.

California Population Density Map
Source: United States Census Bureau data compiled by censusviewer.com

Due to the remote location and distance from other communities, HDSP and CCC mostly
pull staff from the local community of Susanville. More so than any other prison locale,
those that work at the prisons also interact outside the prison on a daily basis. According
to former HDSP staff, many employees’ family members work together, socialize
together, grew up together, and went to school together. Interacting with members of the
prison staff in the community is part of daily life in Susanville. One former employee
who relocated to another part of the State reported that when visiting family in
Susanville, she stopped visiting any of the major grocery stores or shopping centers
because it was inevitable that she would run into former co-workers. Even in the far
reaches of Crescent City and Blythe, where prisons are located, there is still a significant
percentage of staff that commute from different outlying areas and towns.

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Interviews with other former HDSP staff indicated the majority of long term staff at
HDSP are from the local community. Many cadets originally from major metropolitan
areas of the State who graduate from the academy and get assigned to HDSP will leave as
soon as they can transfer to another institution. Former non-white staff reported that
Susanville’s lack of diversity made it an undesirable community in which to live and they
would not choose to return.
Inmate visiting statistics from the last calendar year for a sampling of institutions
demonstrate how isolated Susanville is from the rest of the State. Only Pelican Bay State
Prison (PBSP) located in Crescent City has comparable visitation statistics, making
PBSP, HDSP, and CCC the least visited institutions of those sampled by almost 6,000
visitors per year. On the other hand, California State Prison, Los Angeles County (LAC)
in Lancaster received as many visitors as all three of those prisons combined. Not only
has a lack of visitors been tied to increased recidivism rates, but it also cuts down on the
number of outlets inmates have to report misconduct. Inmates’ friends and family
members are valuable confidants for inmates to report issues they are experiencing inside
the prison.
All of these attributes frame the picture of a location that presents a unique set of
challenges that CDCR should factor into consideration for providing guidance and
accountability over the management of the prisons it has sited there and the needs of the
inmates they have designated for housing in these locations.
Visiting Statistics Calendar Year 2014 8

Institution, Location
Los Angeles County (LAC), Lancaster
Pleasant Valley State Prison (PVSP),
Coalinga
Kern Valley State Prison (KVSP), Delano
Mule Creek State Prison (MCSP), Ione
Folsom State Prison (FSP), Represa
Richard J Donovan (RJD), San Diego
Salinas Valley State Prison (SVSP), Soledad
California State Prison, Sacramento (SAC),
Represa
High Desert State Prison (HDSP), Susanville
Pelican Bay State Prison (PBSP), Crescent
City
California Correctional Center (CCC),
Susanville 9

Number of
Visitors
31,070
28,157
23,764
22,555
22,426
21,758
20,340
17,445
11,488
11,373
7,638

8

The OIG sampled PBSP due to its remote location, SAC and FSP due to their centralized location near the
California capitol, HDSP and CCC due to their location in Susanville, and the remaining institutions
because they house SNY inmates in various locations throughout the State.

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T HE S USANVI LLE “C AR ” M ENTALITY

AND

C ODE

OF

S ILENCE

Interviews of staff formerly assigned to HDSP indicated the existence of tight-knit social
groups among employees, commonly referred to as “cars” within the correctional
community. These groups of employees socialize frequently outside of work and are
often comprised both of supervisors and correctional officers who work on the same
housing units and during the same shifts. In addition, many of the staff are actually
related. Spouses, siblings, and cousins are often employed at one or the other institution,
literally creating “family” ties.
On one hand, some staff described these groups as mostly innocuous; they would eat
lunch together, get each other things from the cafeteria, and barbecue and have drinks
together on weekends. Even these former staff members who did not witness any
misconduct indicated that supervisors who belonged to these groups would sometimes
display favoritism towards the other members of their “car.” One former staff member
stated that supervisors would assign members of their “car” to favorable work
assignments and working hours, such as administrative posts with weekends off, despite
other staff being entitled to the positions by operation of the seniority provisions of the
Bargaining Unit 6, Memorandum of Understanding 10 (MOU) (the correctional officers’
union contract).
On the other hand, some former staff described the negative consequences that could
occur if you were not a member of the “car” or if you spoke out or reported misconduct
against a member of the “car.” These consequences could include unfavorable job
changes, being ostracized and labeled as a “rat,” shunning in the community, retaliatory
investigations, verbal badgering and abuse, the threat of not responding to an inmate
assault on staff, and even physical assault by a custody supervisor.
The actual existence or even the perception of a management “car” can lead staff to
participate in a code of silence, for fear that the consequences of reporting misconduct
will outweigh the risk of remaining silent. Even though the department has a zero
tolerance policy 11 for engaging in a code of silence, the OIG found several examples in
the HDSP cases currently being monitored.

P EER R EVIEW
In response to ongoing reports of issues at High Desert State Prison, CDCR sent a fourperson team to HDSP to conduct a peer review in April 2015. At one time, peer reviews
were conducted on a regular basis, although there is no record of one ever being
conducted at HDSP prior to this one. CDCR reports that a HDSP peer review was
scheduled to occur in May 2010, but did not occur, due to budget cuts.
9

This statistic only includes visitors to inmates housed at CCC in Susanville, not the 18 Northern
California conservation camps associated with CCC.
10
A copy of the MOU can be found at http://www.calhr.ca.gov/Documents/bu06-20130703-20150702mou.pdf
11
A copy of the zero tolerance policy can be found in Appendix D.

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The peer review team interviewed selected members of HDSP staff and inmate advisory
council (IAC) members representing the HDSP inmate populations; randomly
interviewed staff and inmates on each facility; and reviewed a variety of documentation.
The peer review team found 18 areas of non-compliance 12 at HDSP, some of which are
as follows:
•
•
•
•

•
•
•
•

Multiple infractions related to the requirements pertaining to disciplinary action
logs, including failure of management to regularly review and approve.
Lack of program opportunities on the Facility B sensitive needs yard.
Inaccurate documentation on ASU isolation logs, reflecting inmates were
receiving out-of-cell time, when they in fact were not.
Multiple infractions related to the processing of inmate appeals, including appeals
being screened out at a high rate; failure to follow the inmate appeal collection
process outlined in policy; by routing appeals to the mailroom instead of the
Appeals Office; several overdue inmate appeal modification orders; and failure of
the appeals coordinator to meet with the IAC on a quarterly basis, as required.
Underutilization of the custody sick leave monitoring process.
Officers not appropriately completing cell search logs and issuing proper receipts,
coupled with supervisors and managers not completing required weekly and
monthly tours.
Officers modifying inmate programs, without prior approval of the area manager
or Administrative Officer-of-the-Day (AOD).
Custody staff not carrying their required equipment.

While HDSP does have some new staff, the majority are tenured staff who should be well
versed in CDCR’s policies and procedures. The type of errors cited in the peer review are
indicative of lax supervision, complacency, and management indifference. The institution
completed a corrective action plan for all 18 areas of noncompliance and the
overwhelming majority of recommendations made by the peer review team to remedy the
infractions were for staff to be provided training, which was completed. However, one
has to assume that this training was given previously, or should have been. Unfortunately,
by requiring staff only receive one-time training, the department has failed to ensure the
infractions will not continue to occur. There are no safeguards built into the peer review
process, such as requiring HDSP leadership to provide proof that staff have not slipped
back into old behaviors, or requiring the peer review team to conduct a follow-up review
in a few months. Additionally, no one was held accountable for the policy violations or
lack of training in the first place.
The department reports that it is currently in the process of developing a new peer review
process. The OIG recommends that in doing so, in addition to requiring the institution to
develop a corrective action plan addressing the deficiencies, the department must include
a follow-up plan at the headquarters level, to ensure that the identified issues have been
completely remedied and no longer exist. In addition, the tool should include an in-depth
examination of areas such as inmate staff complaints, large volumes of appeals in
12

A copy of the peer review report can be found in the Appendix E.

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particular categories (such as, in the case of HDSP, property), and mandates such as a
measurement of the institution’s compliance with Department Operations Manual (DOM)
Article 44, CDCR’s Prison Rape Elimination Act (PREA) Policy.

R ACISM

AND

I MPLICIT B IAS

In interviews conducted of inmates formerly assigned to HDSP, a common allegation
was the existence of overt racism at HDSP. Several former inmates stated that the racism
they experienced at HDSP was far worse than they experienced at any other institution
where they had been housed. The following excerpts are summarized from individual
inmate interviews, conducted separately over the course of this review:
.. officers called inmates the N-word or wetbacks. Black inmates wouldn’t get enough
time to eat; the officers would ‘kick’ the blacks out of the chow hall first and then the
Hispanics. The white inmates didn’t have to leave, they were running the kitchen.
.. officers were more racist than he experienced at his former prison and the white
inmates were usually allowed to go to canteen first, and when it was the black inmates’
turn, the yard would sometimes be recalled [not allowing time for canteen purchases].
.. never saw such a lack of respect toward black inmates than he experienced at HDSP.
Officers called black inmates the N-word and threatened them. This disrespect occurred
with free staff as well, including medical staff.
.. officers at HDSP were especially disrespectful to black inmates. Officers would search
the cells of black inmates more often than those of other races, and often for no apparent
reason. The disrespect and corrupt environment was far worse at HDSP than other
prisons.
.. the staff at HDSP are absolutely racist. They are just a bunch of hateful people at that
place. It was very different at HDSP compared to other prisons.
.. the white staff were very racist and bigoted, not just towards inmates but also towards
officers that were of different a race. Staff would search the blacks more than others
after chow. It wasn’t the search so much; it was the way they did it. He got that KKK
and green wall feeling from HDSP.
.. there were a lot of disrespectful staff at HDSP. The staff at HDSP were openly racist.
The sergeants and lieutenants were worse than the officers. Blacks were treated very
differently: they are on lockdowns a lot longer; they go to the hole for the smallest of
reasons; and officers messed with their food.
.. officers were racist, called black inmates the N-word, and black inmates were locked
down for longer periods of time than other races.
.. white inmates were assigned the better jobs.
.. officers were racist against black inmates because Susanville was a white community.
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.. officers try hard to not to appear racist, but when you talk to them in private, they use
the N-word when referring to black inmates and use derogatory terms directly to inmates.
.. the biggest issues are race-related. Once heard an officer call blacks “skid marks.”
Regardless of who was involved in an incident, the black population was always held
responsible. Since HDSP was run by predominately white staff, the white inmates were
favored. White inmates always got the better jobs. Clerical jobs were mainly given to
white inmates. Black inmates have to wait at the end of the line during canteen. The
canteen manager allows Hispanic and white inmates to run canteen, resulting in the
black inmates often not getting a chance to have their canteen orders filled.
The racial composition of HDSP’s inmate population and HDSP’s custody staff differ
drastically. Although 76 percent of custody staff are white, only 18 percent of the total
inmate population identifies as white. Hispanic and Black comprise 79 percent of the
inmate population at HDSP, but only 21 percent of the custody staff, which includes
officers, supervisors, and managers.
SEPTEMBER 2015, HDSP RACE/ETHNICITY PERCENTAGES
HISPANIC BLACK WHITE ASIAN
HDSP Inmates
54%
25%
18%
2%
HDSP Custody Officers
20%
3%
74%
3%
HDSP Custody Supervisors &
10%
1%
89%
0%
Managers
*Other includes American Indian, Pacific Islander

OTHER*
2%
1%
1%

OIG interviews highlighted a culture of racism and lack of acceptance of ethnic
differences. From the casual use of derogatory racial terms to de facto discrimination, it
became apparent to the OIG that there is a serious issue at HDSP and that the institution’s
leadership appears oblivious to these problems.
In addition, the remote, rural location and lack of diversity in the Susanville population
could give the perception that non-white residents are not welcome. One former HDSP
staff person stated that he was warned at the academy to be careful in Susanville due to
his race. He said that other non-white staff that had formerly worked in Susanville stated
they would never go back to Susanville, due to its lack of diversity.
The culture at HDSP could benefit from programs that are becoming more and more
prevalent in police departments, which educate officers about the influence of implicit
biases. Implicit bias describes the automatic association people make between groups of
people and stereotypes about those groups. Under certain conditions, those automatic
associations can influence behavior—making people respond in biased ways even when
they are not explicitly prejudiced.
Discussions of implicit bias in policing tend to focus on implicit racial biases; however,
implicit bias can be expressed in relation to non-racial factors, including gender, age,
religion, or sexual orientation. As with all types of bias, implicit bias can distort one’s
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perception and subsequent treatment either in favor of or against a given person or group.
In policing, this has resulted in widespread practices that focus undeserved suspicion on
some groups and presume other groups innocent.
Research has shown that it is possible to address and reduce implicit bias through training
and policy interventions with law enforcement agencies. Research suggests that biased
associations can be gradually unlearned and replaced with nonbiased ones. 13
In 2015, the US Department of Justice (DOJ) announced six cities to host pilot sites for
the National Initiative for Building Community Trust and Justice, which will seek to
assess the police-community relationship in each of the six pilot sites, as well as develop
a detailed site-specific plan that will enhance procedural justice, reduce bias, and support
reconciliation in communities where trust has been eroded. One of the host pilot sites is
Stockton, CA. The three-year grant has been awarded to a consortium of national law
enforcement experts from John Jay College of Criminal Justice, Yale Law School,
UCLA’s Center for Policing Equity, and the Urban Institute.
In addition, law enforcement agencies can request training, peer mentoring, expert
consultation, and other types of assistance on implicit bias, procedural justice, and racial
reconciliation through DOJ’s Office of Justice Program’s Diagnostic Center. The
initiative launched a new online clearinghouse that includes up-to-date information about
what works to build trust between citizens and law enforcement. 14

T HE N EED F O R I NCREASED I NMATE P ROGRAMMING
R ESILIENCY T RAI NING

AND

S TAFF

As described earlier, HDSP houses high security (Level IV) general population and
sensitive needs inmates and medium security (Level III) sensitive needs inmates.
Three of the institution’s four main yards are classified as Level IV housing. HDSP also
maintains a stand-alone administrative segregation unit. As a high security institution,
HDSP houses the most violent and dangerous male offenders.
Prison populations consisting predominantly of people serving long sentences can be
difficult to manage because inmates can have a sense of hopelessness and a “what have I
got to lose” attitude that can lead to continued criminality and violent behavior. Couple
this with half of the HDSP inmate population 15 needing protection due to vulnerability
based on commitment offense or disability, and correctional officers can be unprepared
for dealing with these populations. One way to mitigate these behaviors is through
meaningful programming opportunities and programs that offer incentives to those who
participate, whether that means extra privileges or activities that give a sense of
accomplishment. Unfortunately, HDSP’s Level IV sensitive needs yard has very few
programming opportunities, and the enhanced program facility on its Level IV general
population yard, by staff’s own account, consists mainly of inmates resistant to
13

An article from the Fordham Law Review related to implicit bias can be found in Appendix F.
The clearinghouse can be found at www.trustandjustice.org.
15
Two of the four main facilities at HDSP house inmates designated as sensitive needs.
14

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programming. Increasing programming on these yards and ensuring the right population
is placed into the EPF could reduce the violence and continued criminality that exists at
HDSP.
Working around such dangerous individuals on a daily basis can be a highly stressful
experience. CDCR does not have a program that adequately trains its staff or gives them
the tools to cope with working in such a stressful environment. Additionally, in the
tightknit, rural community of Susanville, where many people work and socialize together,
there are few outlets for staff to seek assistance when they feel their complaints of
mistreatment are not being addressed by prison leadership. There have been staff suicides
reported and some staff reported retaliation for bringing misconduct forward.
There is a staff resiliency training program being developed by the Center for
Mindfulness in Corrections, 16 which CDCR is considering piloting at one of its Level IV
institutions. The program is geared toward developing consistent and healthy self-care
practices and a “safe environment to disengage from negative drama.” This type of
resiliency program is showing promising results in law enforcement agencies across the
country. The department should consider piloting this or a similar program at HDSP, and
then expanding statewide.
In addition, CDCR should ensure HDSP is following the requirements of DOM Sections
33010.30 – 33010.30.3, related to staff in high stress assignments. High stress
assignments are defined as those in controlled housing units requiring direct and
continuous contact with inmates confined therein because they present too great a
management problem for housing in general population settings. Such housing unit
assignments include, but are not limited to: SHUs, ASUs, psychiatric services units, and
protective housing units. The policy requires:
•
•
•

•
•
•

Employees be carefully evaluated before such assignment.
Employees to have demonstrated a high degree of maturity, tolerance, and ability
to cope with stressful situations.
Assignments shall be limited to no longer than two years, with exceptions allowed
by the warden when the employee indicates a desire to remain, or the employee's
performance is completely satisfactory and does not reflect the effect of undue
stress.
Supervisors to evaluate the performance of employees on a continuous basis.
Supervisors to act promptly to remedy stress-related problems that appear to
adversely affect the employee's physical and mental health and effectiveness.
Supervisors to take remedial action including placement in a less stressful
assignment in or outside of the unit.

Increasing meaningful inmate programs and maximizing the EPF participation incentives,
with the goal of decreasing inmate criminality and violence, while at the same time
giving staff the tools to cope with working in a uniquely stressful environment, should
result in improved staff morale and a healthier more resilient staff.
16

An outline of the resiliency program can be found in Appendix G.

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T HE C ALIFORNI A C ORRECTIONAL P EACE O FFICERS
A SSOCI ATIO N
The California Correctional Peace Officers Association (CCPOA) is the labor union
representing correctional officers. CCPOA’s mission is “to promote and enhance the
correctional profession, protect the safety of those engaged in corrections and advocate
for the laws, funding and policies needed to improve prison operations and protect public
safety.” 17 However, during the course of the OIG’s Senate-authorized review, OIG staff
faced significant opposition from the union, which attempted to impede the OIG’s
informational, non-disciplinary interviews aimed at uncovering the veracity of allegations
that the integrity of the correctional profession and the advancement of public safety at
HDSP have been compromised.
Despite PC Section 6126.5’s provision that all CDCR employees shall comply with the
OIG’s requests to be interviewed, with the consequence that failure to comply would be
considered a misdemeanor, on October 15, 2015, CCPOA circulated the following
instruction to its members:

In an effort to maximize its reach, CCPOA e-mailed this instruction as an “Urgent Alert”
to all CCPOA members and some CCPOA chapters recirculated the message on their
Facebook pages. CCPOA based its advisement on the premise that the OIG’s interviews
somehow violated its members’ rights under the Public Safety Officer Procedural Bill of
17

https://www.ccpoa.org/about-us/

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Rights Act [POBR, located at Government Code (GC) Section 3300, et seq.] and the
MOU between the State Employer (CDCR) and CCPOA. CCPOA’s instruction to its
members was not only an inaccurate statement of its members’ legal rights, but it also
encouraged its members to commit acts qualifying as misdemeanor offenses under the
law.
Before beginning the interviews of CDCR employees, the OIG informed the interviewees
that the OIG was not conducting an investigation, that the employee being interviewed
was not the subject of an investigation, and that the OIG would not use any statements
provided during the interviews to initiate an investigation into the interviewee. The OIG
did not permit these employees a representative during the interviews in order to prevent
compromising the integrity of its review. There is a valid concern that CCPOA
representatives were there not to protect any rights of the persons being interviewed,
(who were never at peril of adverse action), but rather to find out which staff were telling
on others, and what they were saying. In fact, none of the people interviewed still work at
HDSP.
Pursuant to GC Section 3303, POBR rights apply only when a peace officer is “under
investigation and subjected to interrogation by his or her commanding officer, or any
other member of the employing public safety department.” Because the OIG employees
who conducted the interviews were not CDCR employees, pursuant to PC Section
6126.5(d), POBR rights did not apply to the OIG interviews unless “it appears that the
facts of the case could lead to punitive action” against the officer being interviewed.
Because the OIG was not performing an investigation into their misconduct and expressly
informed these officers of that fact prior to the interviews, POBR did not provide the
employees being interviewed with any rights to representation during the interviews, any
right to advance notice of the interview, or to be made aware of the subject matter of the
interview. As also set out in PC Section 6126.5(d), the terms of the MOU between the
State and CCPOA do not apply to OIG interviews. No actions were ever contemplated
and none were initiated against any of the interviewed employees.
CCPOA’s State President also attempted to interfere with the OIG’s authorized review by
calling a member of CDCR’s senior management on multiple occasions to complain
about the OIG’s interviews and CDCR’s acquiescence to the OIG’s requests to interview
its employees. This interference also flies in the face of PC Section 6126.5(d), which
requires that “[a]ny employee requested to be interviewed shall comply and shall have
time afforded by the appointing authority for the purpose of an interview with the
Inspector General or his or her designee.”
On November 4, 2015, CCPOA filed a grievance against CDCR claiming CDCR’s
“acquiescence to the Office of the Inspector General’s directives result[ed] in the
violation of several Correctional Officers’ MOU and POBR rights.” Despite every
correctional officer being informed prior to the interviews that they were not the subjects
of an investigation and that they would not become the subjects of an investigation as a
result of information provided during the interviews, CCPOA demanded expedited
arbitration of the grievance, claiming that the OIG’s interviews were causing its members
“irreparable injury … for which there is no adequate remedy at law.” As explained above,
POBR did not provide the interviewees with any rights during their interviews with the
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OIG. Even if officers’ POBR rights had been violated, GC Section 3309.5 provides a
remedy by authorizing the superior courts with initial jurisdiction to adjudicate alleged
POBR violations and issue various forms of injunctive relief, including injunctions and
restraining orders to prevent POBR violations from occurring.
On November 23, 2015, CCPOA’s State President sent a letter to the Governor and each
member of the California State Legislature disparaging the OIG with various unfounded
accusations of impropriety in all facets of its operations. The OIG finds the accusations
baseless, devoid of any understanding of the OIG’s role and function, and disruptive to
the provision of independent oversight as initially ordered by the federal court in Madrid
and later codified by the Legislature. Due to their frivolous nature, the OIG deems
CCPOA’s allegations unworthy of a substantive response. Rather, the letter is the latest
strong-arm tactic CCPOA has elected to deploy in an effort to obstruct the OIG’s Senateauthorized review and attempt to discredit the OIG in advance of the release of this
report.
Finally, on November 24, 2015, CCPOA filed a lawsuit in Sacramento County Superior
Court in which it claims its members’ POBR rights were violated, seeking monetary
damages and injunctive relief. These actions serve as an attempt to chill the transparent
oversight of the correctional system that the department has worked hard to embrace in
the wake of the Madrid federal lawsuit.
CCPOA’s collective actions during the course of the OIG’s review cast into doubt the
genuineness of its stated organizational mission. The union’s staunch opposition to the
OIG’s review of HDSP demonstrates a clear hostility towards transparency and
independent oversight in the prison system. The culture fostered by CCPOA is one of
regression to prior periods of the “green wall” and code of silence, when officers were
actively encouraged to disrupt and sabotage legitimate inquiries into pressing issues of
public policy. This especially exacerbates a situation in a prison with the problems and
culture discovered at HDSP.

R ECOMMENDATIONS

TO

CDCR

•

Infuse HDSP supervisory and management positions with culturally diverse staff
who have experience working in other institutions and do not have lifelong ties to
the community.

•

Consider rotating HDSP management staff to other institutions, similar to the
rotation required for CDCR headquarters peace officer staff.

•

Increase the frequency at which peer reviews are conducted at HDSP.

•

Revise the peer review tool to include follow-up measures and tests that better
assess areas that could indicate deep-seated issues, such as by adding PREA and
ADA compliance components.

•

Increase inmate programming, especially on the SNY facilities.

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•

Ensure inmates housed in enhanced program facilities meet the EPF participation
criteria.

•

Ensure HDSP is following the DOM requirements related to staff in high stress
assignments.

•

Require HDSP seek approval from the CDCR Associate Director, prior to
extending staff in high stress assignments beyond the initial two years.

•

Seek out opportunities to partner with organizations, such as the US DOJ, to
conduct research and provide training to custody staff, starting at HDSP, on how
to recognize and address implicit bias.

•

Implement a mindfulness and wellness program that gives staff resiliency tools to
cope with working in a uniquely stressful environment.

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SEX OFFENDERS AND THE R SUFFIX
R S UFFIX
As part of CDCR’s inmate classification process, inmates with a history of sex offenses
are designated with an R suffix, signifying restricted custody. According to California
Code of Regulations (CCR), Title 15, Section 3377.1(b), the purpose of applying an
R suffix is to ensure the safety of inmates, correctional personnel, and the general public
by identifying inmates with a history of specific sex offenses. Inmates with an R suffix
are automatically assessed a mandatory 19 classification points, which restricts them
from being housed or assigned to jobs or programs outside the prison’s security perimeter
(to reduce the risk of escape).
The R suffix designation follows the inmate for every subsequent incarceration, even if
he has served his term on the initial sex offense and is later recommitted for a different,
non-sex related offense. Regardless of an inmate’s current commitment offense, if that
inmate is required to register as a sex offender, pursuant to PC Section 290, for any
offense committed in his lifetime, an R suffix is applied (in California, PC 290 sex
offender registration is a lifetime registration). In addition, CDCR’s policies require
every arrest, detention, or charge for an offense that would warrant the inmate to register
pursuant to PC Section 290, be evaluated for assignment of an R suffix; the policy is
applied liberally.
The mandatory application of 19 classification points is the ONLY requirement tied to
the R suffix. However, over the years, the R suffix has come to be automatically
associated with the inmate being a sex offender, triggering bias and preconceived beliefs
inmates and officers might have related to sex offenders.
In interviews conducted of former HDSP inmates, allegations were raised related to staff
disclosing the commitment offense of inmates to other inmates, placing their safety at
risk. These former inmates alleged that staff told inmates that other inmates were sex
offenders, or had shown them classification documents or let them view the electronic
inmate records retained in the Strategic Offender Management System (SOMS), showing
that an inmate had an R suffix. Having an R suffix carries a major stigma in prison and
can jeopardize an inmate’s safety by setting the inmate up for assault or extortion for
protection from assault.
The OIG was also told by former HDSP inmates and staff that, more commonly, inmates
are told by other inmates to show their paperwork, which includes the inmate’s
commitment offense. Inmates who are celled together regularly show each other their
paperwork. This occurs on general population yards, as well as sensitive needs yards. The
document being shared is usually a form provided to the inmate documenting the
outcome of their classification committee hearing. Previously, the information was
documented on a Classification Chrono, CDCR Form 128-G; however, it has been
replaced by a printout of the SOMS screen titled Classification Committee Chrono
(Chrono). The information provided in the Chrono not only summarizes the classification
committee’s decisions regarding the inmate’s status, such as clearance for double-celling,
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and education and work assignments, but it also documents the inmate’s case factors
including his commitment offense and prior arrest history. It also includes any applicable
custody suffix, including an R suffix.
In addition to the Chrono, many CDCR forms include an inmate’s commitment offense,
arrest history, or custody suffix information, including the Legal Status Summary, the
Classification Scoresheet, and Crime/Incident Reports. Although staff may be mindful
not to route copies of documents containing sensitive information through inmate mail,
and instead hand-deliver the documents to the inmate, once an inmate is in possession of
these documents he can be pressured to provide them to other inmates. The OIG
recognizes that there are multiple ways inmates can find out about each other’s
commitment offenses; however, limiting the information provided in hard copies given to
all inmates would eliminate one way in which this information is discovered and reduce
the pressures faced by inmates which then lead to victimization. The department cites no
penological reason that information related to R suffix, commitment offense, or arrest
history must appear on the Chrono given to the inmate.
With the implementation of SOMS and staff’s ability to review inmate records in realtime, it is recommended that CDCR review any forms and documents that have required
the commitment offenses and R suffix information, and determine if including this
information is necessary and who has a need to know. CCR, Title 15, Section 3375(h),
requires that an inmate be provided a copy of all non-confidential CDCR staff-generated
documentation and reports placed in the inmate’s central file, unless otherwise requested
in writing by the inmate. Inmates who are pressured to provide a document to verify their
commitment offense may be placed in a predicament if they request that their
documentation not be provided since one can then assume that the inmate is hiding
something.
The dangers associated with an inmate’s paperwork and R suffix are all too real. In May
2013, on an SNY facility (not HDSP), an officer discovered an inmate lying unresponsive
on the floor of his cell with a sheet pulled over him and a classification document resting
on top of the sheet. There was a ligature around the inmate's neck, wound tight by a
connected State-issued cup, and blood near his head. The classification document found
on the deceased inmate noted that his commitment offense was for lewd and lascivious
acts with a child under 14 years of age.
Additionally, as recently as December 2015 on an SNY facility (not HDSP), an inmate
with a history of in-cell violence and gang affiliation informed an officer that his cellmate
was dead. The victim was found face down on the floor and hogtied with multiple
injuries and a pen and pencil stabbed in the victim’s ear. Written on the victim’s t-shirt
were derogatory slurs specific to his criminal history. Although the victim’s current
offense was not a sex offense, he had sex offenses in his history.

SOMS A CCESS
In the last few years, CDCR has converted from a paper inmate file, to an electronic
inmate record. While this has made major improvements, it has come with the unintended
consequence of giving staff unfettered access to an inmate’s history. In the past, staff
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wanting to know if an inmate was a sex offender would have to visit the prison records
office, request the inmate’s hard copy file, sign in on a log sheet, and sit in the records
office to review the file. Now, from just about every housing unit in a prison, with a few
key strokes and no admonishment or reminder that the information contained therein is
sensitive and confidential, anyone accessing SOMS can instantly know if an inmate has
an R suffix. In fact, the very first screen that appears after entering the inmate’s CDCR
number contains the R suffix information in the header.
In addition, although these SOMS computers are considered to be out of bounds for
inmates, their placement throughout the housing units can sometimes be in areas where
inmates can see the information on the screen. While the OIG recognizes that there are
legitimate penological reasons that custody staff may need to access some information
from an inmate’s electronic record, for instance, to verify an inmate has no enemy
concerns before rehousing him on another yard, custody staff must be mindful of the
sensitive information being displayed on the computer monitors. Additionally, most
custody officers do not have a need to know most information regarding inmates’
commitment offenses.

R ECOMMENDATIONS

TO

CDCR

•

Develop a policy authorizing staff to access an inmate’s electronic record on a
“need to know” basis only. The policy should add admonishment language to the
SOMS login screen, advising against misuse, and the consequence thereof.

•

Develop a method of tracking and recording staff access to records in SOMS and
other inmate records, and periodically audit access history to identify potential
misuse.

•

Remove the R suffix information from the SOMS header, as any staff specifically
needing this information can find it on another screen.

•

Conduct an in-depth review of every form and document that currently requires
commitment offense information and R suffix notations, and remove this
requirement from all forms and documents where it no longer serves a legitimate
purpose.

•

Consider providing inmates with only hard copies of certain portions of nonconfidential documentation from SOMS or other inmate records, to exclude
commitment offenses, R suffix notations, and any other information that may put
an inmate at risk.

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SENSITIVE NEEDS YARDS
When sensitive needs yards were first conceptualized in the late nineties, they were
developed with the expectation that inmates would volunteer to be housed on a yard
where they would pledge to program, in return for a “violence free” environment. There
are no policies or procedures related to SNY housing, only a loose set of placement
consideration guidelines outlined in a single memo from 2002. Essentially, the
department did not want to establish rigid criteria for SNY placement, but rather a caseby-case review of each inmate would be conducted by the classification committee.
SNYs do not have additional programming or anything different than general population
facilities, as they were perceived to be truly a GP placement for inmates who simply wish
to live in a nonviolent environment. The memo grouped inmates appropriate for SNY
housing as falling into one of the following general categories:
•

Prison Gang Dropout – these inmates had to be validated by CDCR’s Office of
Correctional Safety as a gang dropout.

•

Victim of Assault – these inmates may have been assaulted because of a
commitment offense or failure to commit an ordered assault on another inmate.

•

Significant Enemy Concerns – these inmates may have provided testimony in
open court, or their status as snitches or informants may have become known to
the general inmate population.

•

Other Safety Concerns – these inmates may be high notoriety, public interest
cases, or sex offenders. These inmates might also include those that refuse to
recognize inmate-imposed racial or cultural lines and other safety concerns not
specifically listed.

The memo instructed staff to take a liberal approach to placing an inmate in an SNY and
a conservative approach on any considered action to remove an inmate from an SNY.
Additionally, the department foresaw that as the number of inmates receiving and
requesting SNY housing grew, so would the need for SNY beds. These facilities “simply
become housing for programming inmates who are willing not to prey upon other
inmates in exchange for a feeling that they are less likely to be preyed upon” [emphasis
added].
Because CDCR considers SNY facilities to be no different than GP facilities, SNY staff
have never received any training in supervising vulnerable populations. However, unlike
GP facilities, CDCR does not require SNY facilities to have an ethnic balance for inmate
program and job assignments, leading many SNY inmates to complain that other races
are receiving the best job assignments.
The demand for sensitive needs housing has grown to over 37,000 inmates being
designated SNY. CDCR staff no longer wait for inmates to volunteer or request SNY
housing. It is common now for classification staff to recommend SNY housing to inmates
who have committed a sex offense or other crimes that make them targets for violence.
Many vulnerable inmates who accept SNY housing do so expecting a protective
environment and it is not always explained to them by classification staff that sensitive
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State of California

needs yards are still violent, have programming no different from GP yards, and once
they are assigned to an SNY, it is very difficult to ever return to a general population
yard.
The growing numbers of gang dropouts being placed in SNYs has resulted in numerous
new gangs forming and warring with rivals on the SNYs. Gang violence has grown so
bad that some SNY inmates have asked to return to mainline yards rather than continue to
face the gangs on the SNYs. However, once an inmate has been housed on an SNY
facility, he then becomes a target or is labeled as soft, making it very difficult to ever
transfer out. In fact, CDCR’s SNY guidelines acknowledge that SNY housing in itself
adds a label or stigma to the inmate and under no circumstances will an SNY inmate be
returned to a GP if it is believed that the inmate’s safety would be threatened by such
housing, not even inmates who repeatedly assault other SNY inmates.
As one former HDSP staff member stated, inmates take a very dim view of other inmates
who have committed various crimes, mostly sex offenses. And they tend to target them for
assaults, for extortion, for a whole variety of negative actions. Many of the assaults that
happen, you could probably break down into a couple of categories, inmate-on-inmate
assaults that are debts, generated from drugs or protection or bribery or blackmail. Then
there's the gang-related assaults that happen when somebody is not toeing the line where
they are supposed to, and they need to be removed from the picture from the inmate point
of view. And so it's really hard to say the frequency of assaults– it happens all the time.
To further gauge the amount of violence occurring on sensitive needs yards compared to
general population yards, the OIG analyzed CDCR’s COMPSTAT 18 reports for the 13month period from June 2014 through June 2015. The OIG compared the data reported
for the Average Number of Incidents per 100 Inmates and found that, of the ten facilities
with the highest number of incidents per 100 inmates, 80 percent of the institutions
housed SNY inmates. The OIG then compared the data reported for the Average Number
of Inmate Disciplinary Actions, per 100 Inmates and found that of the twenty facilities
with the highest number of inmate disciplinary actions per 100 inmates, 70 percent of the
institutions housed SNY inmates. 19
Finally, the OIG compiled the COMPSTAT data for the number of inmate disciplinary
actions for specific violent offenses 20 issued at each institution. 21 Unfortunately, CDCR’s
COMPSTAT data is not broken down by individual facility within a prison, so the OIG is
unable to compare individual SNYs within a prison to GP or other yards. However, as
indicated in the following table, institutions housing SNY inmates (highlighted in green)
have violence prevalence similar to institutions housing GP inmates.

18

COMPSTAT data can be found at www.cdcr.ca.gov
See Appendices H and I for number of incidents and disciplinary actions.
20
The violent offenses included: assault on staff, battery on staff, assault on inmate, battery on inmate,
attempted murder, and murder.
21
Data was unavailable for the California Health Care Facility and the California City Correctional
Facility. Additionally, there are no SNYs at female institutions.
19

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State of California

Inmate Disciplinary Actions (115’s) for Specific Violent Acts, June 2014 through June 2015
June
June
Total
115s for Monthly 2015
2015
SNY
Institution
All Levels
Mission
Violent
average Inmate
SNY
Levels
Acts
Count
Pop
WSP
NKSP

672
612

51.69
47.08

4881
4365

N/A
N/A

SAC
LAC
SOL
CAL

572
562
430
420

44.00
43.23
33.08
32.31

2319
3494
3866
3774

N/A
896
N/A
922

CCI
HDSP
SVSP
SATF

326
324
323
318

25.08
24.92
24.85
24.46

3931
3300
3678
5581

3186
1009
1468
3156

COR
KVSP
DVI
SCC
CCC
PVSP
CMF

287
286
235
222
212
209
184

22.08
22
18.08
17.08
16.31
16.08
14.5

4405
3638
2117
4345
4089
2271
2269

1850
1578
N/A
788
N/A
1274
N/A

PBSP
CEN
CIM
MCSP
CMC
ISP
RJD
SQ
FSP
ASP
CRC
VSP
CTF
CVSP

177
173
173
165
154
154
142
121
114
112
89
79
72
50

13.62
13.31
13.31
12.69
11.85
11.85
10.92
9.31
8.7
8.62
6.85
6.08
5.54
3.85

2742
3489
3802
2941
3809
3401
3148
3687
2876
2766
2434
3379
5167
2264

N/A
871
1810
2778
N/A
1561
2118
N/A
N/A
2324
784
3326
2668
1178

I, III, RC
I, III, RC
I, IV, PSU,
SHU
I, III, IV
II, III
I, IV
I, II, III, IV,
SHU
I, III, IV
I, III, IV
II, III, IV
I, III, IV,
SHU, PHU
I, IV, THU
I, II, RC
I, II, III
I, II, III
I, III
I, II, III
I, IV, PSU,
SHU
I, III, IV
I, II, RC
I, III, IV
I, II, III
I, III
I, III, IV
II, RC
I, II, FWF
II
II
II
I, II
I, II

N/A
N/A

RC
RC

N/A
IV
N/A
IV
I, II, III,
IV
III, IV
III, IV
II, III, IV

HS
HS
GP
GP

III, IV
IV
N/A
III
N/A
III
N/A

HS
HS
RC
RC
RC
GP
FOPS

N/A
III
II
I, III, IV
N/A
I, III
III, IV
N/A
N/A
II
II
II
II
I, II

HS
GP
RC
GP
RC
GP
RC
RC
FOPS
GP
RC
GP
GP
GP

HS
HS
HS
HS

Also indicative of the increased violence in SNYs is the proportion of inmate homicides
that occur involving victims assigned to SNY housing. In the OIG’s October 2014 SemiAnnual Report, Volume II, it reported on the homicides that took place on sensitive needs
yards. Of the 11 inmate-on-inmate homicides reported, 10 occurred on Level IV sensitive
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State of California

needs yards, 8 of which were in-cell homicides. In addition to the 11 homicides, another
case reported was an in-cell great bodily injury case that also occurred on an SNY
facility, but did not result in death.
In addition to the cases noted above, a 2012 SNY homicide at HDSP involved an inmate
strangling his cellmate to death in their cell. The aggressor was convicted for murder and
the victim for multiple violent sex offenses. The aggressor had been placed on the
sensitive needs facility because he had been attacked during intake, upon his arrival at
HDSP. The question later arose as to why a violent murderer had been celled together
with a sex offender. Subsequent investigation determined that CDCR has no policies
requiring an analysis of housing compatibility on sensitive needs yards.
Also at HDSP, a 2013 SNY homicide involved an inmate with a history of in-cell
violence strangling his cellmate to death in their cell. The aggressor was convicted for
murder and rape in 1994 and the victim for sex offenses against minors in 2011. They
had only been celled together for 16 days.
In the OIG’s assessments of these events, it became clear that there are steps that the
department can take to lessen such risks. The assumption that placement in SNY housing
includes an implied agreement by SNY inmates to co-exist peacefully is no longer a
viable premise, especially in light of the fact that CDCR staff no longer wait for an
inmate to volunteer before designating him for SNY housing. CDCR does not complete a
double-cell housing compatibility review form for SNY inmates. This form is intended to
ensure that inmates are properly placed with compatible cellmates and that potential
cellmates are given the opportunity to document their agreement to house together or
expose reasons why they should not be housed together. Similar forms are not used on
GP yards either, but the inherent volatility created by mixing a sex offender and violent
gang member (albeit a dropout) does not typically exist on a GP yard.
The OIG further determined that the department’s policy for changing an inmate from
single-cell to double-cell status is insufficient. The policy states in part: A classification
committee may consider whether an inmate with single-cell designation has since proven
capable of being double-celled. The policy does not provide specific guidelines or
examples of how an inmate that previously assaulted cellmates can prove capable of
transitioning back to double-cell status. As a result of these findings, in the OIG’s
October 2014 Semi-Annual Report, Volume II, the OIG issued CDCR the following
recommendations:
•

Institute compatibility guidelines requiring the completion of CDCR Form 1882A, General Population Double Cell Review and completion of the CDCR Form
1882-B, Administrative Segregation Unit/Security Housing Unit Double-Cell
Review to help ensure that inmates are properly housed with compatible
cellmates.

•

Require potential cellmates to document their agreement to house together.

•

Provide clear guidelines for transitioning single-cell designated inmates to
double-cell status on SNY facilities.

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State of California

•

Require that SNY inmates' central files be reviewed for propensity for violence
and prior assaultive behavior before double-celling, or at least prior to placement
with a vulnerable cellmate (part of the CDCR Form 1882-A process).

The department initially declined to implement any of these recommendations, but later
agreed to develop a classification system to identify inmates that are at risk of being
assaulted and to identify inmates that are likely to assault other inmates. With this new
system, CDCR hopes to ensure inmates from these two groups are not celled together.
The new classification system is expected to be implemented in early 2016.
Finally, as heard repeatedly in interviews with former HDSP staff, the lack of quality
programs at HDSP is a factor leading to inmates having nothing to do and causing
tensions to rise. As stated earlier in this report, one way to mitigate criminality and
violence is to increase program opportunities for the inmate population.

R ECOMMENDATIONS
•

TO

CDCR

Address the growing violence on sensitive needs yards by:
o developing formal policies and procedures related to SNY housing;
o considering the development of separate SNY housing criteria for vulnerable
inmates at risk of assault;
o transferring aggressors to some other type of housing;
o re-examining the double cell policy for sensitive needs yards pursuant to
previous OIG recommendations;
o requiring completion of a compatibility review, similar to the CDCR Form
1882-B, Administrative Segregation Unit/Security Housing Unit Double Cell
Review; and
o reviewing the process for transitioning inmates from single-cell designation to
double-cell status, pursuant to prior OIG recommendations.

•

Add more meaningful programs to sensitive needs yards, especially Level IV
SNYs such as HDSP’s Facility B, where programs have been historically lacking.

•

Ensure that classification staff designating inmates as requiring SNY placement,
inform inmates that SNYs are still violent, have programming no different from
GP yards, and once assigned to an SNY, it is very difficult to ever return to a
general population yard.

•

Require training for SNY staff in supervising vulnerable populations.

•

Require racial balance criteria for inmate program assignments in SNY housing,
at least at HDSP (similar to general population facilities), to overcome the
perception of racial bias.

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State of California

INMATE APPEALS AND STAFF
COMPLAINTS
A PPEAL C OLLECTION

AND

P RO CESSING

The OIG reviewed dozens of complaints, filed by both inmates and staff, related to the
processing of inmate appeals. Some of the allegations included:
•

Appeals were being destroyed or discarded, never being delivered to the Appeals
Office.

•

Appeals were being read by officers, and if the appeal contained a complaint
against staff, the inmate was subjected to retaliation or the appeal was destroyed.

•

Staff complaints were never addressed.

•

Appeals were being shredded by Appeals Office staff.

As referenced earlier, the OIG published a review in September 2011 of CDCR’s inmate
appeals process, finding the process does not provide enough accountability to address
inmate allegations that appeals are subject to intentional destruction or negligence. In
response to OIG recommendations, the department issued a December 30, 2011, directive
to all institutions, which, among other mandates, included the following:
•

A secure appeals lock box is required on every yard and in each building, retrieval
from which shall only be done by Appeals Office staff and/or staff designated by
the warden.

•

Reading or inspecting the contents of appeals by anyone outside of Appeals
Office staff is prohibited.

At HDSP, neither of these directives were implemented. The OIG’s review found that the
first watch program sergeant is delegated the responsibility for collecting appeals from
the lock boxes and delivering them to the Appeals Office. The key to each lock box is on
each program sergeant’s key ring, which is passed from the first watch sergeant to the
second watch sergeant to the third watch sergeant. This of course means that throughout
the course of any given day, many different people have access to read, tamper with, or
destroy inmate appeals.
Appeals may also be submitted through the mail. All inmate mail not marked as legal
mail, including inmate appeals, is opened, read, and examined for contraband by HDSP
officers. As an aside, department managers were unable to explain why a letter addressed
to the Appeals Office within the prison needed to be opened and examined for
contraband. Once read and examined, instead of routing the appeals directly to the
Appeals Office, officers were placing the mail into a mailbag for delivery to the
mailroom, where it would once again be subject to review by mailroom staff, before
finally arriving at the Appeals Office.

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Additionally, inmates housed in the administrative segregation unit or on modified
program during a lockdown, cannot personally deposit their appeals in a lock box in any
institution. In these situations, the same staff who provide day-to-day supervision of the
inmates in their assigned housing units personally collect the appeals from the inmates’
cells and are then supposed to deposit them into the lock box on the inmates’ behalf.
HDSP’s appeals collection process allows inmate appeals to pass directly through the
hands of those who might have an interest in the complaint, whether that be the officer
being accused of misconduct, that officer’s friend (or quite possibly neighbor), or a
supervisor who may be friends with the accused officer. This process decreases
individual accountability and thwarts HDSP’s ability to determine who is responsible if
the appeals lock box has been tampered with or if an inmate’s appeal goes missing.
As reported above, in 2011, the OIG found that the appeal process lacks an accountable
means of verifying that appeals are made and lacks an accountable means of delivering
appeals. The report recommended CDCR add a receipt feature to its appeal form so that
appeals could be tracked; allow inmates to make copies of their appeals; and implement
accountability measures, such as requiring Appeals Office staff to directly collect inmate
appeals instead of custody staff.
The OIG reiterates its recommendations from its 2011 report, and in addition, the
department must address the issue of inmates in ASU or on a modified program during
lockdown who are unable to personally place their appeal into a lock box. This can be
remedied by mandating Appeals Office staff personally retrieve the appeal from the
inmates’ cells or instituting some form of secure mobile collection process.

V OLUME

OF

A PPEALS

AT

HDSP

During the 18-month period of January 1, 2014 through June 30, 2015, the HDSP
Appeals Office logged 5,711 appeals. The following table indicates property complaints
are overwhelmingly the most appealed issue, at more than double the amount of the next
highest appeal category. Although the topic of lost or destroyed inmate property is not the
focus of this review, the sheer volume of property appeals should signal to HDSP
management that there are systemic issues related to its handling of inmate property that
need to be addressed.
During interviews of inmates and parolees formerly assigned to HDSP, a few stated that
staff would take an inmate’s property and give it to another inmate in exchange for a
favor. One inmate mentioned a particular staff member who was known for giving
confiscated inmate property to other inmates as a reward for assaulting inmates. Another
inmate said that he had seen staff take property from inmates involved in assaults, place
the property on a table, and later allow other inmates to take it.
The OIG found during the course of its review that staff do not always have a clear
understanding of the policies and procedures related to the processing and handling of
property. In addition, the OIG is currently monitoring an internal affairs investigation
related to allegations of officers tampering with inmate property as a ruse to confiscate
the property. The OIG will report on the outcome of the case at the conclusion of the
investigation.
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State of California

HDSP Appeals January 2014 – June 2015
Facility
HDSP-A
HDSP-ASU
HDSP-B
HDSP-C
HDSP-D
HDSP-E
(MSF)
HDSP-H
(CTC)
HDSP-Other
Grand Total

Appeals
1246
396
1136
1127
1229
42
80
455
5711

Appeal Issue
PROPERTY
CUSTODY/CLASS.
DISCIPLINARY
ADA
LEGAL
STAFF
COMPLAINTS
LIVING
CONDITIONS
FUNDS
WORK INCENTIVE
MAIL
CASE RECORDS
PROGRAM
TRANSFER
VISITING
MEDICAL
SEGREGATION
RE-ENTRY/PAROLE
Grand Total

Appeals
1539
580
510
412
410
384
318
305
256
253
228
220
148
58
43
39
8
5711

In addition to the appeals above, during this same timeframe, over 2,000 health care
related appeals were responded to by HDSP’s health care services department. The most
appealed health care issues were related to medication, disagreements regarding
treatment decisions, issues related to reasonable accommodations for ADA inmates,
access to care, referrals, and issues related to reasonable accommodation medical devices.
Unlike regular appeals, which are stored in an inmate’s electronic file, health-care-related
appeals, due to HIPAA laws, are kept in the Health Care Appeals Tracking System. If a
health care appeal is received in the Inmate Appeals Office by mistake, it is re-routed to
the Health Care Appeals Office for response.

S TAFF C OMPLAINTS
When an inmate wants to file a complaint against a staff person, it is handled by Appeals
Office staff in a manner similar to a regular appeal, with a few exceptions. The policy for
processing a staff complaint can be found in CCR, Title 15, Section 3084.9(i), titled
Exceptions to the Regular Appeal Process. Basically, the policy requires the inmate
alleging staff misconduct by a departmental employee to forward the appeal to the
appeals coordinator who in turn must forward it to the hiring authority (at a level not
below chief deputy warden) with a recommendation on whether to process as a regular
appeal or handle as a staff complaint.

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If the hiring authority determines it should not be handled as a routine appeal, the hiring
authority has the following options:
(1) If the hiring authority determines the alleged conduct would likely lead to
adverse personnel action, the case will be referred for an internal affairs
investigation by CDCR’s Office of Internal Affairs.
(2) If the hiring authority determines the alleged conduct does not warrant a
request for an internal affairs investigation, a confidential inquiry shall be
completed by whomever at the prison the hiring authority designates.
The staff complaint process can be very frustrating for the appellant inmate, as the
confidential nature of the proceedings give little feedback to the inmate. The inmate is
only informed whether or not the complaint is being referred for an investigation or
confidential inquiry and then the final outcome of the investigation or inquiry. The
inmate does not receive a copy of the confidential report; however, the accused staff may
review the confidential report in the Appeals Office upon approval of the prison’s
litigation coordinator.
The OIG reviewed the HDSP logs for staff complaints filed at HDSP from January 1,
2014, through June 30, 2015. The OIG found that of the 807 staff complaints filed, only
282 were referred for investigation. This is not uncommon in CDCR, as individual staff
complaint determinations tend to come down to the inmate’s word versus the word of
staff, and allegations of misconduct can be difficult to prove.
807
34
491
267
5
10

HDSP Staff Complaints - January 1, 2014 - August 18, 2015
Total number of staff complaints processed by the HDSP Appeals Office.
Cancelled. Usually due to the issues being identified as duplicative of another appeal.
Processed as a routine appeal after being deemed not to meet the criteria for
assignment as a staff complaint.
Processed as a staff complaint. Referred to an Associate Warden for inquiry, due to
adverse action being unlikely.
Referred to HDSP's Investigative Services Unit for an allegation review to gather
additional information.
Referred to CDCR's Office of Internal Affairs for investigation, based on a reasonable
belief that misconduct occurred.

As illustrated in the table above, in all but ten of the HDSP staff complaints, the hiring
authority decided to handle the complaints internally. Only about one percent of all the
staff complaints filed were ever reviewed by anyone outside of HDSP. Additionally, in
one of the ten cases where HDSP reported it had been referred for an outside
investigation, there is no evidence that the complaint ever actually left the institution.
The OIG noted that there were several staff who had multiple staff complaints filed
against them from several different inmates. The alarming number of complaints should
have triggered HDSP management staff to look more closely at the totality of the

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State of California

circumstances surrounding the complaints, such as deficiencies in supervision; however,
management never correlated multiple complaints against officers.
HDSP is not consistently logging its allegations of misconduct, which is required by
DOM Section 31140.13; therefore, it cannot accurately track the status of complaints
referred for inquiry or investigation, nor can it easily recognize potential areas of concern
related to allegations being lodged repeatedly against the same staff or in the same work
area.

D ISINCENTIVES

TO

F ILING S TAFF C OMPLAINTS

The appeal collection process places inmate appeals directly in the hands of the officers
being accused of misconduct. This creates a significant disincentive for inmates to file
appeals; knowing that the officers they are accusing of misconduct will be handling or
reading the appeals will likely dissuade an inmate from filing a complaint. When an
inmate does file a complaint against staff, the inmate is often placed in administrative
segregation for their own “protection,” which is yet another disincentive.
However, even if the appeals collection process is changed in a manner that precludes
custody staff from reading or handling inmate appeals, the CCPOA MOU contains a
provision that mandates that officers who are accused of misconduct by inmates be
immediately notified of the contents of all inmate complaints filed against them. Section
9.09 of the Bargaining Unit 6 MOU states:
(D) Whenever a ward/inmate/parolee/patient files or submits a grievance,
a 602 (Inmate Appeal), any written complaint, or verbal complaint which
is later reduced to writing by either the inmate or the State, which, if found
true, could result in adverse action against the employee or contain a threat
against the employee, the Department agrees to immediately notice the
employee of said filing. The State agrees to provide the affected employee
a copy of said document if the employee so requests. This is not intended
to preclude the informal level response procedure in the current CDCR
Operations Manual. Upon the employee’s request, a copy of the outcome
of the ward/inmate/parolee/patient’s complaint shall be provided, if the
complaint has progressed beyond the informal stage. The Employer and
CCPOA agree that all video tapes, audio tapes or any other kind of
memorialization of an inmate/ward/parolee/patient statement or complaint
shall be treated as a writing within the meaning of this subsection. The
tapes or writings shall be turned over, regardless of whether the
complaint/statement is deemed inmate/ward/ parolee/patient initiated or
not.
The department’s appeal process fails to protect the identity of the inmate accusing an
officer of misconduct and unjustifiably exposes the inmate to retaliation for filing a
complaint. The appeal process is the inmate’s main avenue for resolving issues and the
OIG was repeatedly informed that inmates choose to no longer file appeals for fear of
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State of California

reprisal. CDCR’s own peer review found additional deficiencies in HDSP’s appeal
processing.
CDCR’s headquarters Appeals Office has responsibility for ensuring institutions have the
necessary training and assistance needed relative to the appeal system; conducting audits
of appeals units; and meeting with CDCR administrators to review policy and procedure
needs as revealed by inmate appeals. It does not appear that the headquarters Appeals
Office has done any of these related to High Desert State Prison, which could greatly
benefit from oversight, training, and assistance.

R ECOMMENDATIONS

TO

CDCR

•

Create a formal policy that reflects the contents of the December 30, 2011, memo
titled: Secure Appeal Collection Sites and Related Matters, but require appeals in
lock boxes be retrieved by Appeals Office staff only.

•

Add a receipt feature to the CDCR Form 602, Inmate/Parolee Appeal, or assign a
log number to all appeals at the point of collection.

•

Immediately reiterate that initial appeal content is to be read by Appeals Office
staff only, until assigned out for response.

•

Provide HDSP staff with training relating to the processing and handling of
inmate property and hold officers accountable for failing to abide by the relevant
policies and procedures.

•

Require institutions to conduct a management review into an employee’s
performance and worksite when multiple staff complaints are filed by multiple
inmates against an individual employee.

•

Revisit DOM Section 31140.14, and develop a procedure to ensure staff
completing allegation inquiries have received approved internal affairs
investigation training, prior to being designated and/or approved by CDCR’s OIA
or OIA investigators.

•

Require staff performing allegation inquiries into staff complaints receive formal
internal affairs investigations training prior to conducting allegation inquiries.

•

Ensure hiring authorities and managers reviewing allegation inquiry reports are
trained to recognize complete, thorough, and adequate allegation inquiry reports.

•

Develop an accountability process for ensuring hiring authorities are keeping
accurate and complete CDCR Form 2140, Internal Affairs Allegation Logs, in
accordance with DOM Section 31140.13, which requires each allegation of
employee misconduct be logged, regardless of whether the allegation is referred
for investigation.

•

Renegotiate Section 9.09 of the Bargaining Unit 6 MOU to treat inmate appeals in
the same manner as any other allegation of staff misconduct.

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State of California

•

Remedy the inability of inmates in ASU or on a modified program to personally
place their appeal into a lock box, by mandating Appeals Office staff personally
retrieve the appeal from the inmates’ cells or instituting some form of secure
mobile collection process.

•

Dispatch staff from the Appeals Office to conduct an in-depth audit of HDSP’s
appeal process, provide any remedial training necessary, and report back to
CDCR administrators any policy or procedure deficiencies revealed by a review
of HDSP inmate appeals, such as property issues and the handling of staff
complaints.

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State of California

USE OF FORCE INCIDENTS
HDSP U SE

OF

F ORCE F REQ UENCY

As part of this review of High Desert State Prison, the Senate Committee specifically
requested the OIG review practices related to excessive use of force against inmates,
internal reviews of incidents involving excessive use of force against inmates, and
protection of inmates from assault and harm by others.
The OIG analyzed and compared a variety of use of force documents and data points,
spanning, unless otherwise noted, the 18-month period of January 1, 2014, through June
30, 2015. This included several dozen use-of-force incident packages, staff complaints
alleging excessive or unnecessary use of force, disciplinary logs and rules violation
reports, confidential inmate files related to force allegations, complaints filed directly
with outside stakeholders, and internal affairs investigations. In addition, the OIG
interviewed several inmates formerly housed at HDSP.
From the data gathered by the OIG, it developed the following tables to get a snapshot of
how HDSP compares to other similar facilities, and how the facilities within HDSP
compared to each other.
The table below compares the total number of incidents to the total number of incidents
involving use of force, and the percentage of incidents involving use of force, that
occurred on Level IV SNY facilities.
Incident Data, Level IV SNY Facilities 22

Facility
HDSP-B
CAL-D
COR-03B
KVSP-C
KVSP-D
LAC-C
MCSP-A
RJD-C
SATF-D

Total # of
Incidents
227
91
343
226
204
217
334
209
128

Total # of
Incidents
Involving Use of
Force
173
49
176
118
141
134
214
98
80

Percent of
Incidents
Involving Use
of Force
76%
54%
51%
52%
69%
62%
64%
47%
63%

22

SVSP and CCI also have a Level IV SNY; however, they went through their conversions during this
timeframe, so comparable data was not available.

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This data demonstrates that HDSP’s Level IV SNY Facility B had the highest percentage
of incidents involving the use of force, compared to other Level IV SNY facilities.
The next table compares the number of inmate disciplinary actions for a variety of serious
or violent offenses to the total number of all inmate disciplinary actions, for each yard at
HDSP.
HDSP Inmate Disciplinary Actions
Inmate Disciplinary Actions
January 1, 2014-July 31, 2015

HDSPA

HDSP-B
(SNY)

HDSP-C

HDSPD

Inmate Disciplinary Actions for Serious
or Violent Offenses
All Inmate Disciplinary Actions

337

805

354

387

643

1076

486

548

Percent of Disciplinary Actions for
Serious or Violent Offenses

52%

75%

73%

71%

This data demonstrates that a significantly higher number of disciplinary actions occurred
on Facility B, with a higher percentage involving serious or violent offenses, compared to
the other HDSP facilities.
In addition to reviewing incident data, the OIG has been reviewing every use of force
incident package and attending every Institutional Executive Review Committee 23
(IERC) meeting since March 2015, 24 where the warden and executive staff review every
use of force incident package. Reviews conducted by the OIG find that the majority of
the incident packages and staff reports are thorough and the IERC conducts a fair review.
It should be noted that IERC reviews are only as thorough as the reports available for
review. If fights are instigated or staff are not fully reporting the force used, this will not
be apparent in the reports. Additionally, unlike institutions with yard cameras, staff
reports are the only source of information related to HDSP use-of-force incidents for the
IERC to review.
In the OIG’s 2012 report related to sex offender abuses at High Desert State Prison, some
of the officers interviewed indicated that they believed there were officers at HDSP who
would provoke inmates into physical altercations to necessitate the use-of-force. The
inmate interviews conducted by the OIG are consistent with the picture the data paints of
High Desert State Prison as an institution with a high level of violence. The interviews
are also consistent with inmate complaints the OIG read in appeals and also in letters
written to the OIG and received from outside stakeholders.

23
24

IERC requirements can be found in CCR, Title 15, Section 3268, Use of Force.
Prior to March 2015, the OIG would attend at least one IERC meeting at HDSP per month.

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The following excerpts are summarized from individual inmate interviews, conducted
separately over the course of this review:
.. officers are slow to respond to incidents.
.. always concerned that an incident could erupt at any time.
.. had safety concerns due to his commitment offense.
.. officers at times were slow to respond during riots.
.. felt less safe than other prisons.
.. an officer sent an inmate to attack him, and then the officer and his buddies sat and
watched.
.. constantly afraid at HDSP, and had never been afraid at any other prison. It was the
officers he was afraid of, and not the inmates.
Additionally, the OIG was told that staff who had previously worked at HDSP and then
transferred to CCC were heavy-handed and quicker to “jump” to using force.
The OIG is also currently monitoring a number of internal affairs investigations related to
excessive or unnecessary force which are detailed in the Internal Affairs Investigations
portion of this report. The OIG will report on the outcome of these cases at the
conclusion of the investigations. All of these incidents currently being monitored
allegedly occurred between October 2014 and September 2015.
With an appeals process that is fatally flawed and a staff complaint process that results in
only about one percent of complaints getting referred for an outside investigation,
coupled with staff’s unwillingness to report misconduct for fear of reprisal, it is very
difficult to prove excessive or unnecessary use of force. However, inmates continue to
utilize all available avenues to report alleged abuses, including writing letters to the
CDCR Ombudsman, the OIG, the Prison Law Office, the Legislature, and the Governor.
Until the department takes steps to address these issues, outside stakeholders will
continue to place a heightened level of scrutiny on HDSP.

T HE N EED F O R C AMERAS

IN

A LL I NMATE A REAS

In the OIG’s September 2015 Semi-Annual Report, it was noted that one area where the
department agrees but has yet been unable to address, is the placement of cameras on all
yards and in all housing units. Such surveillance is invaluable in capturing misconduct,
documenting inmate activity, and exonerating employees who have been wrongly
accused of misconduct. The OIG monitors all incidents involving the use of deadly force,
as well as incidents involving lesser force that may not have complied with departmental
policy. Often times there are conflicting accounts of what transpired, making it difficult
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to assess whether the force used complied with policy. High quality visual recordings of
incidents can serve to resolve these conflicting accounts. In addition, there are many rule
violations and crimes inmates commit that visual recordings could memorialize for just
resolution. However, most institutions still lack cameras, including HDSP.
Installing cameras at High Desert State Prison should be the department’s number one
fiscal priority. Allegations of excessive and unnecessary use of force, inmate abuse, and
staff misconduct have been relentlessly lodged at HDSP for years, and with evidence of
lax supervision and sustained cases of officers failing to report use of force that they
observed, cameras are the absolute best tool for CDCR to curtail misconduct and
exonerate staff falsely accused of using unnecessary or excessive force.
When deciding on a camera system to install, the OIG recommends that the department
look to the system installed at the California Health Care Facility or the California City
Correctional Facility, and ensure the cameras are installed in all inmate areas.

T HE N EED

TO

P ILOT

A

P RO GRAM U SING B ODY C AMERAS

In addition to installing cameras in all inmate areas, CDCR should pilot a program
similar to the program piloted by the Wisconsin Department of Corrections (WDOC).
According to the WDOC, it partnered with a company known as Taser International to
conduct a pilot program using body cameras in its Waupun Correctional Institution
(WCI). The pilot was designed to enhance staff professionalism, reduce sexual assault
allegations, staff assaults, inmate complaints regarding staff, and use of force incidents.
At the conclusion of the pilot, WCI found that there was a reduction in the number of use
of force incidents; however, PREA allegations and inmate complaints remained
consistent.
WCI found the body cameras to be very effective for interactions at cell doors and when
speaking to inmates. They were not effective while escorting inmates; however, the audio
provided perspective as to what was taking place.
In the beginning of the pilot, WDOC reported that staff were apprehensive about wearing
the cameras, while the inmate population appeared to be playing to the camera,
attempting to provoke an unprofessional response from staff. Training regarding
professional communication skills was conducted with all staff involved in the pilot and
after a couple of weeks, staff were comfortable wearing the cameras and the inmates had
adjusted as well. The pilot showed that the cameras enhanced the professionalism of staff
and how they communicated with inmates.
Although the number of complaints and PREA allegations did not decrease during the
pilot, the camera footage made it easier to review the allegations and determine if an
incident occurred. The use of body cameras by police departments has also had a positive

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impact of enhanced officer safety and reduced liability, and as the WDOC pilot shows, it
appears that similar benefits can also be achieved within correctional settings. 25
In piloting the use of body cameras, the OIG recommends that CDCR choose at least one
building on HDSP Level IV SNY facility. This will enable the department to compare
incident and disciplinary data, among other things, to other buildings housing similar
inmates. The OIG further recommends that the body cameras be equipped with GPS
(global positioning satellite) geotagging technology, which is a common feature in body
cameras. This feature could be important to determine the location of staff during
incidents at any particular point in time, improving officer safety and possibly disproving
staff misconduct allegations.

A LLEGATIONS T HAT S TAFF A RE S LOW
I NCIDENTS

TO

R ESPOND

TO

Although the earlier table shows that HDSP has a high percentage of incidents involving
the use of force, several inmates previously housed at HDSP said that staff would pick
and choose which incidents to respond to with force. Inmates stated officers were
sometimes deliberately slow to respond to incidents and intervene when inmates
assaulted one another. Two recent incidents occurred at HDSP, where staff reports
suggest a delayed response and failure to use force when it appears force was necessary
to stop serious injuries to the victims from multiple attackers. The details of these
incidents are as follows:
Staff observed three inmates attacking another inmate on the yard by punching the
victim with their fists. One officer reported that it took ten minutes before the inmates
finally complied with staffs’ orders to get down into a prone position. As staff finally
approached the incident, the combatants ceased their attack. Staff reports state that the
victim lost consciousness during the incident and was transported to an outside
hospital for serious bodily injuries, including a broken nose, broken orbital socket,
and stitches to his left eye. Force was not used to stop the attack.
Staff observed four inmates attacking another inmate on the yard by punching the
victim with their fists, while one of them stabbed the victim multiple times with an
inmate manufactured weapon. Staff reports state that staff gave multiple orders for
the inmates to get down, but the combatants continued their assault. As staff finally
approached, the combatants ceased their attack. Staff reports state that the victim was
transported to an outside hospital for serious bodily injuries, including more than
30 lacerations and puncture wounds to his face, neck, stomach, head, and back areas.
Force was not used to stop the attack.
Allegations that officers are slow to respond to incidents are exceedingly difficult to
adjudicate. There is no system currently in use that documents where officers are within
25

A copy of WDOC’s pilot report at WCI can be found in the Appendix J.

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the prison. One solution would be to use GPS or RFID (radio frequency identification)
type tags to document where officers are in the prison. Not only would these types of
allegations be easy to resolve, but the use of this type of technology would be a
significant enhancement to the safety and security of the individual officers. No officer
could ever be isolated without someone knowing their location.

R ECOMMENDATIONS

TO

CDCR

•

Immediately install cameras in all inmate areas, including, but not limited to, the
exercise yards, rotundas, building dayrooms, patios, and program offices of
HDSP.

•

Implement a pilot program in at least one building on HDSP’s Level IV SNY
facility, requiring custody staff to wear body cameras, similar to the pilot
conducted at Wisconsin’s Waupun Correctional Institution. Ensure the body
cameras are equipped with GPS geotagging technology. Collect, compare, and
report the resulting incident, disciplinary, and other relevant data for the buildings
with body cameras and the similar buildings without body cameras, for possible
statewide pilot program expansion.

•

Ensure that HDSP custody supervisors are scrutinizing all incidents where
inmates receive serious injuries, and hold accountable officers who fail to timely
respond to incidents and fail to use force when appropriate to stop potential
deadly attacks.

•

Consider using GPS or RFID type technology to document where within an
institution an officer is located.

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ARMSTRONG REMEDIAL PLAN – ADA
INMATES

D ISABILI TY P LACEMENT P RO GRAM
In 1994, a class action lawsuit (known as Armstrong) was brought against the department
under the Americans with Disabilities Act and the Rehabilitation Act on behalf of
inmates and parolees with disabilities. The resulting court-ordered Armstrong Remedial
Plan 26 is the department’s framework for ensuring inmates are not excluded from
programs, services, or activities, and are not discriminated against, due to a disability.
The Disability Placement Program (DPP) is the department’s set of plans, policies, and
procedures related to Armstrong. Inmates with permanent mobility, hearing, vision, and
speech impairments, or other disability or compound conditions severe enough to require
special housing and programming, are to be placed in a designated DPP facility. HDSP
has been a designated DPP facility since at least 1997. Inmates with a permanent
impairment of lesser severity may be assigned to any of the department's institutions
consistent with their existing classification factors.
The number of DPP inmates at any institution varies from day to day. In October 2015, of the
more than 3,000 inmates housed at HDSP, approximately five percent (165) were DPP
inmates, who were housed on various yards throughout the institution based on their
classification factors.
HDSP DPP Inmates
Mobility Impaired
(not impacting placement)
Full Time Wheelchair User
Hearing Impaired
(not impacting placement)
Mobility Impaired
Intermittent Wheelchair User
Vision Impaired
Hearing Impaired
Total DPP Inmates 27

58
30
28
19
17
10
3
165

At the designated facilities, the department is required to provide reasonable
accommodations or modifications for known physical or mental disabilities of qualified
inmates. Examples of reasonable accommodations include: special equipment (such as
26
27

A copy of the Plan can be found on CDCR’s website, at: www.cdcr.ca.gov
In addition, 19 of the 165 DPP inmates also had a secondary disability.

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readers, sound amplification devices, or Braille materials), inmate or staff assistance,
bilingual or qualified sign language interpreters, modified work or program schedules, or
grab bars installed for mobility impaired inmates who require such.
Ultimately, when an inmate requests a durable medical device or an accommodation,
custody staff must initially provide the device or accommodation to the inmate and then
refer the inmate to a physician to determine whether the accommodation or device is
needed for the disability. Custody staff does not have the authority to deny an
accommodation or medical device unless there is a demonstrated security concern.

C ALLOUS T REATMENT

OF

DPP I NMATES

During the OIG’s review, allegations surfaced that staff callously disregarded an inmate’s
claimed disability and that a general culture of indifference to the plight of severely
disabled inmates exists at HDSP. The OIG is currently monitoring three investigations
that illustrate this culture of indifference. HDSP referred one of these investigations on its
own; the other two cases would not have been referred for investigation, but for this
review.
Case Number 1
In this case, an inmate who had mobility impairment was virtually ignored by staff for
hours. The Armstrong issues arose after a use-of-force incident. The inmate, who wore a
leg brace to prevent foot drop due to an injury that occurred prior to his commitment to
State prison, was confronted about alleged contraband shoes that he was wearing. When
he refused to voluntarily relinquish the shoes, the shoes were forcibly removed. When the
shoes were removed, custody staff also confiscated his leg brace. During that incident,
the inmate received a head injury and a leg injury which required him to be taken to an
outside hospital for a higher level of care.
When he returned from the hospital, he was in a wheelchair and was dressed in an orange
jumpsuit (the type of jumpsuit inmates wear when outside the prison). He was directed to
remove the jumpsuit and to return to his housing unit to pick up his issued blue prison
clothing. His wheelchair was also taken from him. He protested that, because of his
injuries, he could not walk and needed the wheelchair. By this time, he was only dressed
in boxer briefs. He was told by custody staff that he did not have an authorization for a
wheelchair and that he needed to walk back to his housing unit to get dressed. It should
be noted that prior to the altercation he did walk with a cane and with a leg brace. The
inmate protested that he could not walk and needed the wheelchair and was told by
custody staff “when you get tired of sitting here you will get up and walk back to your
housing unit.” He remained outside the housing unit for an extended period of time while
custody staff simply ignored him sitting there in his boxer briefs. At some point, a
lieutenant noticed him sitting there and asked him why he was simply sitting there. The
inmate explained that he could not walk back to the housing unit and, at this point, the
lieutenant retrieved a wheelchair and had the inmate delivered to a medical clinic.

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The inmate remained in the medical clinic for several more hours, sitting in a holding cell
in his boxer briefs. Again, there is no evidence that staff inquired as to what his condition
was and why he was sitting there. Finally, the same lieutenant who had delivered him to
the medical clinic observed him sitting there and again inquired as to why he was just
sitting in the medical clinic. The inmate again informed the lieutenant that he needed help
getting back to his housing unit and at that point the lieutenant made arrangements for the
inmate’s cellmate to take the inmate back to his housing unit in a wheelchair. After
finally arriving at his cell, the inmate remained for several days without a wheelchair and
was unable to participate in programming. There is no evidence that custody checked on
the inmate until he was transferred to another institution several days later.
There appears to have been a complete disregard for this inmate during the hours that he
was simply sitting trying to get back to his housing unit and further disregard after he was
in his cell.
Case Number 2
In this case, a wheelchair-bound inmate resisted being placed in a cell, claiming that he
had safety concerns with the other occupant of the cell. The officers disregarded his
safety concerns and physically picked him up out of the wheelchair and threw him into
the cell. The door to the cell was then closed and the wheelchair was thrown against the
door, damaging the wheelchair. Neither the use of force nor the damage to the wheelchair
was reported. In addition, an inmate who could not ambulate was left in the cell without
his wheelchair.
Case Number 3
In this case, a hearing impaired inmate who was wearing a vest noting that he was
hearing impaired was slightly injured during a use-of-force incident. The inmate was
receiving a package through Receiving and Release and for reasons still not clearly
understood; the inmate became upset regarding his package. There was no sign language
interpreter and it does not appear that the officer ever tried to establish effective
communication.
The account of what happened becomes somewhat confused at this point with officer
witnesses claiming that the inmate took a bladed stance and raised his fists while inmate
witnesses consistently claim that this inmate turned around to leave and was tackled from
behind. What is clear is that no reasonable attempt was made to establish effective
communication with an inmate who has been deaf and speechless since birth.

I NTERNAL C OMPLIANCE R EVIEWS

AND

P LAINTIFF T OURS

As part of this authorized review, the OIG reviewed CDCR internal Armstrong
compliance reviews and the reviews done by plaintiffs’ counsel. The department has not
done an internal compliance review since 2013, while plaintiffs’ counsel has done a
review within the past few months.
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CDCR’s 2013 internal Armstrong compliance review showed a decrease in compliance
from the prior review done in 2011. After the 2013 compliance review, a final corrective
action plan was required; however, the corrective action plan was not submitted until
March 24, 2015.
In contrast, the most recent plaintiffs’ counsel tour and document review at HDSP was
conducted from August 18 – 21, 2015. Plaintiffs’ counsel conducts yearly tours of each
CDCR institution. The most recent Plaintiff Armstrong monitoring tour found HDSP
significantly out of compliance in several areas. Many of the serious violations identified in
this report have been previously identified by Plaintiffs, but never effectively addressed or
remedied by the institution. The areas of noncompliance found by Plaintiffs are broadly
documented in the following areas:
I. MANAGEMENT FAILURES PREVENT THE INSTITUTION FROM
RECOGNIZING AND REMEDYING VIOLATIONS

Plaintiffs believe that management has not embraced the reforms mandated by the
Armstrong remedial orders. Plaintiffs allege that prison management fails to identify or
stop violations from occurring. Plaintiffs report that inmates who were interviewed have
claimed that staff retaliate against prisoners who request disability accommodations.
These reports have remained consistent from year to year. What is most troubling is that
the department has not investigated these complaints, seemingly dismissing them because
they come from inmates.
For several years, a consistent complaint has been that appeals “disappear” or “go
missing.” Interviews of inmates by Plaintiffs’ counsel have been consistent with
complaints received by the OIG about appeals that have gone missing or are not acted on.
The OIG’s review of the appeals system at HDSP noted that the institution is not
collecting appeals as directed by a memo authored by a former Director of Adult
Institutions, which directed institutions to collect appeals with personnel other than
officers who may be subjects of staff complaints. HDSP tasks housing officers on first
watch to collect the appeals. This practice sets the department up for allegations that
officers who may be the subject of a complaint are interfering with the complaint process.
II. THE YARDS ARE INACCESSIBLE AND PRISON STAFF DO NOT BELIEVE
THERE IS ANY DURABLE REMEDY

Plaintiffs allege that the paths of travel throughout the yards at HDSP are inaccessible to
people with mobility and vision impairments. Cracks that appear two or three inches wide
and one-half to two inches deep run throughout each of the prison yards, making the
yards unsafe for prisoners with significant mobility and vision impairments. Path of
travel problems throughout the yards are longstanding, and are the subject of numerous
reports and appeals as documented in the Plaintiffs’ March 2014 HDSP report.
There appears to be no immediate ongoing remedial plan to improve accessibility of all
paved areas at the prison and at all times of year. Although CDCR expects to complete
“master plan” repairs to HDSP, those repairs are not expected to begin until mid-2016.
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Again, it appears that there is no management emphasis on making the yards accessible
in the near term.
III. VIOLATION OF STATE MOBILITY IMPAIRED VEST POLICY
Prison staff confirmed that the policy at HDSP is to require everyone to sit down on the
ground when there is an alarm – including those wearing mobility vests. This is contrary to
the statewide policy stated in a February, 25, 2014, Memorandum from the Director of Adult
Institutions and the Director of Health Care Operations at the California Correctional Health
Care Services (CCHCS) to all wardens, which states that “inmates wearing a MI [Mobility
Impaired] Vest are not required to attain a seated position” during alarms. This violation of
policy is particularly concerning because the identical violation was identified in the
Plaintiffs’ March 2014 HDSP report.
IV. LACK OF EFFECTIVE INMATE DISABILITY ASSISTANT PROGRAM
The Inmate Disability Assistant Program (IDAP) is not functioning adequately at HDSP, as
IDAP workers are not allowed out of their cells during their work hours unless they are
specifically called by a correctional officer to provide help; IDAP workers are not trained;
and IDAP workers were instructed to perform inappropriate tasks including carrying canteen
items for prisoners and, more troubling, one IDAP worker was instructed to place his
cellmate in waist-chain restraints.
V. FAILURE TO ACCOMMODATE PRISONERS WITH HEARING
IMPAIRMENTS
Class members reported that staff failed to allow the use of telecommunication devices for
the deaf (TDD) phones, failed to provide sign language interpretation, and failed to
communicate alarms and announcements.
VI. OTHER CUSTODY STAFF FAILURES ALLEGED BY PLAINTIFFS’ COUNSEL
Failure to maintain ADA cells in working order
There was water leaking from the ceiling in numerous wheelchair-accessible cells on facility
B and the ADA staff had been unaware of these leaks until Plaintiffs raised them. If prison
staff had been conducting the safety checks and ADA features checks required by the local
operating procedures, staff would have identified and remedied these leaks earlier.
Failure to provide orientation materials
Numerous class members who had recently arrived to the prison reported that they had not
received orientation, including information regarding the purpose of the DPP; availability of
the CCRs, ARP, and similar printed materials in accessible formats; reasonable
accommodations or modifications available to qualified inmates; access to readers or scribes
and availability of specialized library equipment.
Lack of access to day room showers
Numerous inmates with disability placement wheelchair (DPW) status throughout B yard
reported that they have difficulty accessing the ADA showers because so many non-disabled
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prisoners use that shower, and because prisoners with disabilities who have mobility devices,
prostheses, or incontinent supplies, often require additional time to complete their showers.
This issue has been raised in numerous appeals, and in numerous prior reports.
Laundry
Incontinent prisoners throughout the institution reported to Plaintiffs’ counsel that when they
have accidents, they are unable to get clean clothing or laundry. That complaint has been
relayed to management with no evidence of management action.
Lack of knowledge of the new durable medical equipment (DME) policy
Interviews with class members suggest that custody staff still demand Chronos for hygiene
supplies, such as toilet paper. Numerous prisoners throughout the institution who are
incontinent as a result of their disability also reported that they are denied access to a shower
when they have an accident. The same issues were reported last year.
Failure to provide restroom accommodations in the library
Library staff confirmed that prisoners are not allowed to access restrooms while in C or D
facility libraries. This poses a problem for class members who, because of their disability, are
incontinent and may need immediate access to a bathroom.
Mismanagement of prisoner property
Plaintiffs received a number of complaints from class members claiming that prison staff
allow other prisoners go through their personal property and, as a result, items are stolen. The
OIG has also received the same type of complaints.
VII. HEALTH CARE STAFF FAILURES ALLEGED BY PLAINTIFFS’ COUNSEL
Delayed provision of durable medical equipment
A number of prisoners complained of improper delays in receipt of ordered durable medical
equipment. A review of the DME logs and receipts indicate additional delays.
Wheelchair repair problems
Although the local operating procedures require HDSP staff to evaluate each wheelchair each
day to determine if it is in safe working order, it is apparent that this is not occurring. Nor are
staff taking appropriate steps to ensure that broken wheelchairs are repaired. This same
problem was reported last year.
Erroneous charges for durable medical equipment supplies
Plaintiffs identified numerous instances where class members were inappropriately charged
for wheelchair gloves and hearing aid batteries.
Failure to provide needed toileting supplies
Monitors received reports that disabled inmates had not received needed toileting supplies,
such as colostomy supplies, gloves, chux, tape, or bio bags.

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Confusing or incomplete documentation of disabilities and failure to ensure effective
communication
Plaintiffs received reports that medical staff failed to ensure effective communication with
hearing impaired prisoners.
VIII. APPEALS STAFF RESPONSIBILITIES
HDSP recently implemented the Reasonable Accommodation Panel (RAP) process for
addressing requests for disability accommodations and/or allegations of disability
discrimination.
Inappropriately identifying requests as “non-ADA”
RAP responses continue to include language inappropriately identifying ADA
accommodation requests as “non-ADA”. For example; an inmate reported that R&R staff
made him choose whether to transfer with his wheelchair or with his property. The RAP
response inappropriately states that this issue is “non-ADA related” even though failing to
transfer prisoners with their ADA assistive devices is a violation of the ADA and Remedial
Plan.
Failure to identify accountability issues raised in appeals
Multiple appeals alleged Armstrong violations on the part of staff members were not flagged
for Armstrong accountability investigations.
Improperly construing access issues
Plaintiffs’ counsel identified a tendency on the part of the RAP to narrowly construe the
definition of equal access to programs, services, and activities. For example, one inmate
stated that he was in special education previously and is now “unable to focus on things or
take knowledge in.” He requests transfer to a prison that will help him learn properly. The
RAP response form inappropriately states that “no issues were identified with access to
program, services, or activities.” Access should not be construed as physical access only; it
also includes barriers resulting from communication and learning difficulties.
IX. ACCOUNTABILITY
This report and prior tour reports allege violations of the ADA, the Armstrong Remedial
Plan, and Armstrong Court orders. Pursuant to the August 22, 2012, order, CDCR must
“track any allegation that any employee of the Department of Corrections and Rehabilitation
was responsible for any member of the Plaintiff class not receiving access to services,
programs, activities, accommodations or assistive devices required by” the ADA, the Court’s
Orders, or the Remedial Plan. “All such allegations shall be tracked, even if the noncompliance was unintentional, unavoidable, done without malice, done by an unidentified
actor or subsequently remedied.” The order contains detailed requirements regarding the
timing and content of investigations and investigation reports. Plaintiffs’ counsel reviewed
the CDCR and CCHCS “Employee Non-Compliance Logs” for the months of January – May
2015. Defendants recorded a total of 423 incidents during those months. Of those,
investigations are still ongoing in 76 cases. Of the cases where investigations were
completed, employee non-compliance was confirmed in 325 (or 77 percent of) cases. In

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addition, Plaintiffs’ counsel found seven allegations of non-compliance in appeals that did
not appear in the logs, but should have.
DEPARTMENT RESPONSE

After the Plaintiff tour and report, the department provided a response that, for the most
part, acknowledges the deficiencies found by Plaintiffs. The almost universal response by
the institution management to these deficiencies is that “staff will be trained.”
This response does not address the underlying concerns about why staff has not already
been trained, and who is accountable for the lack of training. For example, one deficiency
found in the August 2015 tour was that mobility-impaired inmates were being required
by HDSP custody staff to prone out on the yard when an alarm was sounded. The
directive excusing mobility impaired inmates from this requirement was published by the
Director of Adult Institutions in February 2014. The underlying concern is why staff is
not already trained in this area and who should be held accountable for the lack of
training. Prison managers have not been held accountable for these lapses.
The above information documents a profound lack of management and custody staff
emphasis on ADA issues in a facility designated to house disabled inmates. Staff is not
sensitive to the needs of disabled inmates nor does staff appear to consider ADA
accommodation to be an important aspect of custody duties.
The OIG’s review found evidence that insensitivity to these issues still exists.

R ECOMMENDATIONS

TO

CDCR

•

Move the DPP inmates to another Armstrong-designated institution, if paths of
travel and accessibility cannot be immediately fixed at HDSP.

•

Revise the ADA tab in the SOMS computer system to:
o Better capture details of an ADA inmate’s accommodation needs. For
instance, instead of only stating that an inmate has an accommodation for
“shoes,” insert a detailed description, or even a picture of the shoes.
o Include a place to record the doctor’s name.
o When applicable, describe the specific restraint accommodation needed, such
as “waist restraint.”

•

Train staff on Armstrong Remedial Plan and ADA requirements, document the
training, and when new violations occur, hold both the offending officers and
their supervisors accountable for failure to follow or enforce the training.

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INTERNAL AFFAIRS INVESTIGATIONS
Over the past few years there have been a significant number of misconduct complaints
levied against staff at High Desert State Prison. However, especially over the last 12
months, there have been numerous instances in which the hiring authority has failed to
refer cases of serious misconduct to CDCR’s Office of Internal Affairs for investigation.
Additionally, a concern has arisen regarding CDCR’s assignment of “resident special
agents,” particularly at High Desert State Prison. Resident agents are OIA special agents,
but they do not work out of the Office of Internal Affairs; instead their office is located
within the prison they are assigned to investigate. Thus, they are enmeshed into the
culture of the prison and not in an independent office at a centralized location away from
the prison, like the majority of the other OIA special agents.

H IRING A UTHORI TY R EFERRALS
I NQUIRIES

AND

I NTERNAL A LLEGATION

DOM Chapter 3, Article 14 sets forth the department’s policies regarding internal
investigations. Section 31140.14 gives the hiring authority the discretion to direct
“locally designated investigators approved by the OIA or OIA investigators [special
agents]” to conduct an allegation inquiry when there is an allegation of misconduct,
which if true could lead to adverse action, and the subject(s), allegation(s), or both are not
clearly defined or more information is necessary to determine if misconduct may have
occurred.
The locally designated investigator is often times a sergeant or higher ranking member of
the institution’s Investigative Services Unit (ISU).
The hiring authority is required to maintain a log on a CDCR Form 2140, of all
allegations of staff misconduct, regardless of whether the allegation is referred for
investigation. The log must also state whether or not an allegation inquiry is being
conducted and the resulting action from the allegation inquiry (e.g., referred to OIA for
investigation, processed as a CDCR Form 602, Inmate/Parolee Appeal Form, or found to
not have merit). 28
If sufficient evidence is known or obtained through an allegation inquiry to warrant an
internal investigation, the hiring authority is to refer a CDCR Form 989, Confidential
Request for Internal Affairs Investigation. 29 Upon receipt of a referral, the Office of
Internal Affairs decides whether to open an investigation, refer the case to another entity
for an investigation, return the case to the hiring authority without an investigation for
direct disciplinary or corrective action, return the case for further inquiry, or determines
that no action is necessary. Pursuant to PC Section 6133, the OIG is responsible for the
28
29

DOM, Chapter 3, Article 14, Section 31140.13.
DOM, Chapter 3, Article 14, Sections 31140.4.10 and 31140.4.14, and 31140.4.15.

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contemporaneous public oversight of the investigations conducted by the Office of
Internal Affairs and for advising the public regarding the adequacy of each investigation
and whether discipline of the subject of the investigation is warranted.
During the review of HDSP, several areas of concern arose related to allegation inquiries.
First, HDSP is not keeping a consistent CDCR Form 2140, Internal Affairs Allegation
Log. This makes it very difficult for HDSP to identify staff who have repeated allegations
of misconduct made against them and this lack of transparency makes it difficult to
determine what action, if any, High Desert State Prison management has taken regarding
specific allegations of misconduct made against HDSP staff.
Second, when allegation inquiries are conducted, one route that can be taken is to close
the case, without referring the case to OIA for an investigation, if the person conducting
the allegation inquiry finds that the allegation has no merit and the hiring authority
agrees. Unfortunately, there actually is no process for OIA to appoint “a locally
designated investigator,” so the persons conducting allegation inquiries are appointed by
the hiring authority with no “designation” from the Office of Internal Affairs.
Additionally, there is no required training for persons conducting allegation inquiries, and
there is no training for hiring authorities to recognize what is an adequate enough
allegation inquiry to deem it unnecessary to refer to OIA for an investigation. Therefore,
the quality of allegation inquiries varies widely, and without a consistent Allegation Log,
it is difficult to determine what the hiring authority has decided to do when allegations of
misconduct become known. One thing we do know for sure is that there were many
allegations of staff misconduct that HDSP management chose not to refer for
investigation (please refer to the following).

A LLEGATIONS

OF

M ISCO NDUCT I NVOLVING HDSP S TAFF

The OIG learned of several allegations of misconduct involving HDSP staff and urged
both HDSP and CDCR’s Office of Internal Affairs to take action. The cases described
below are examples of staff misconduct allegations the HDSP hiring authority did not
refer for investigation, and would not have been investigated, but for this review.
•

An officer allegedly directed expletives at inmates including derogatory language
and racial slurs. The officer’s misconduct placed inmates and staff in a dangerous
situation, and as inmates became agitated, two additional officers heard the
statements and failed to report the officer’s misconduct. The Office of Internal
Affairs concluded its investigation and is in the process of forwarding its report
and investigative materials to the hiring authority for a decision on whether or not
to sustain the charges.

•

An officer allegedly threatened an inmate that he would be assaulted if the inmate
refused to sign a form declaring that the inmate did not have enemy concerns on
the yard. The officer allegedly had the inmate assaulted by other inmates. The
Office of Internal Affairs investigation is still in progress.

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•

An officer allegedly called an inmate a "baby killer" and disclosed the inmate's
criminal history to other inmates, creating a serious security risk for the inmate.
The same officer allegedly pulled an inmate’s pants and underwear up to the
middle of his back during a routine search. The officer also attempted to humiliate
the inmate in front of others, and threatened him. In retaliation for the inmate’s
complaint regarding this incident, that officer and another officer allegedly
conducted a search of the inmate’s cell and wrote false rules violations reports
against the inmate and his cellmate for possession of inmate manufactured
alcohol. The second officer also allegedly falsely attested that a sergeant
confirmed that alcohol was found in the cell. The sergeant allegedly neglected his
duty when he signed the rules violation report before completing a review of the
document. The Office of Internal Affairs concluded its investigation and is in the
process of forwarding its report and investigative materials to the hiring authority
for a decision on whether or not to sustain the charges.

•

Officers allegedly provided confidential criminal history about an inmate to other
inmates, after which the inmate was assaulted. The Office of Internal Affairs
concluded its investigation and forwarded its report and investigative materials to
the hiring authority for a decision on whether or not to sustain the charges.

•

An officer allegedly yelled abusive comments toward an inmate and then directed
the control booth officer to turn the power off on the lower tier. The control booth
officer allegedly turned the power off on the lower tier, and placed the inmate in
jeopardy when he announced to the other inmates that the power outage was due
to the inmate. The Office of Internal Affairs concluded its investigation and is in
the process of forwarding its report and investigative materials to the hiring
authority for a decision on whether or not to sustain the charges.

•

Two officers allegedly falsely claimed that an inmate’s property had another
inmate’s name on it and confiscated it as contraband. An officer allegedly
removed security screws from an inmate’s television as a ruse to confiscate the
property as contraband. The Office of Internal Affairs investigation is still in
progress.

•

An officer allegedly used physical force to take a hearing-impaired inmate to the
ground and repeatedly slammed his head onto a concrete floor. The Office of
Internal Affairs concluded its investigation and is in the process of forwarding its
report and investigative materials to the hiring authority for a decision on whether
or not to sustain the charges.

•

A nurse issued non-standard shoes to an inmate as a medical accommodation. The
shoes had a red stripe. A captain, without resolving the medical accommodation
needs of the inmate, allegedly determined the shoes were contraband and ordered
officers to seize the shoes from the inmate. The officers also seized a leg brace
from the inmate. When the officers attempted to seize the shoes, the inmate
resisted and officers used physical force and allegedly injured the inmate during

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the incident. The inmate suffered an injury to his pre-existing disabled leg and a
cut to his forehead necessitating medical attention at an outside hospital. When
the inmate was returned to the institution the same day, officers initially refused to
assist him to his cell with a wheelchair. The inmate was left to remain on a patio
and then in a medical holding cell for several hours without proper attire
considering the weather conditions. The Office of Internal Affairs concluded its
investigation and is in the process of forwarding its report and investigative
materials to the hiring authority for a decision on whether or not to sustain the
charges.
•

Prison officials allegedly failed to respond to safety concerns expressed by an
inmate. Subsequently, the inmate was assaulted. The Office of Internal Affairs
concluded its investigation and forwarded its report and investigative materials to
the hiring authority for a decision on whether or not to sustain the charges.

•

Two officers and a sergeant allegedly solicited an inmate to commit assaults on
another inmate who had masturbated in front of a female sergeant. The Office of
Internal Affairs investigation is still in progress.

•

Several officers allegedly disclosed an inmate’s confidential criminal history to
other inmates. Subsequently, the officers allegedly approached the inmate’s cell,
cursed at him, discussed his case, and said that he “deserves to die.” An officer
then allegedly arranged for the inmate to be assaulted. The Office of Internal
Affairs investigation is still in progress.

In the following instances, the hiring authority identified possible misconduct and
referred the cases to the Office of Internal Affairs:
•

An officer allegedly told an employee, she should join the green team, inmates are
not human, and that the institution is a zoo. The officer also allegedly slammed
his baton onto the counter and stated, “I have my own version of progressive
discipline.” The Office of Internal Affairs determined that an investigation was
not necessary, as there was sufficient evidence of misconduct, and returned the
case to the hiring authority to take direct action. The hiring authority imposed a
salary reduction.

•

An officer allegedly taunted an inmate in a mental health crisis bed, banged the
door to the inmate’s cell with his baton, and then covered the inmate’s window
with paper. The Office of Internal Affairs investigation is still in progress.

•

Six officers allegedly responded to an inmate’s safety concerns by physically
picking him up out of his wheelchair, throwing him into a cell, and then damaging
the wheelchair by throwing it against the closed cell door. The six officers also
allegedly failed to report their use of force. A seventh officer who was working in
the control booth in the building failed to report the force that he observed. The
Office of Internal Affairs investigation is still in progress.

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•

An officer allegedly failed to report a second officer’s use of force. During the
incident, the control booth officer allegedly failed to maintain observation of the
officers and inmates. The Office of Internal Affairs investigation is still in
progress.

•

An OIA resident agent released confidential information regarding multiple
internal investigations, including information regarding a pending criminal
investigation. The hiring authority demoted the special agent, who returned to his
former lieutenant position at High Desert State Prison. Shortly after his return, the
HDSP acting warden at the time placed him in an acting captain position.

•

An employee relations officer allegedly failed to report that an OIA special agent
had improperly divulged confidential information. The special agent allegedly
falsely advised the employee relations officer that he had reported his misconduct
to a senior special agent. The employee relations officer allegedly withheld
information during an interview with the Office of Internal Affairs. The OIA
concluded its investigation and the hiring authority imposed a salary reduction
against the employee relations officer, who resigned before the penalty was
served.

•

Two non-custody staff allegedly released confidential information pertaining to
the internal investigations of several employees. One of the employees was
allegedly dishonest during an interview with the Office of Internal Affairs and
allegedly discussed the interview with another employee after being ordered not
to do so. The hiring authority sustained the allegations, dismissed the dishonest
employee, and imposed a salary reduction against the other.

•

An officer allegedly subjected another officer to threats and intimidation for
failing to use lethal force on inmates during a prior incident when the inmates
assaulted custody staff. The Office of Internal Affairs investigation is still in
progress.

Several of these investigations involve allegations meriting dismissal if sustained. It
should be noted that there are some officers involved in multiple cases.

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O FFICE

OF

I NTERNAL A FFAIRS R ESIDENT A GENTS

CDCR’s Office of Internal Affairs has started assigning “resident agents” to institutions
located in hard-to-reach areas. In addition to the recent retirement of the resident agent
assigned to the California Men’s Colony (CMC) in San Luis Obispo, resident agents were
assigned to the following institutions:
•
•
•
•
•
•
•

Chuckawalla Valley State Prison – Blythe, CA
California State Prison, Centinela – Imperial, CA
High Desert State Prison – Susanville, CA
California Correctional Center – Susanville, CA
Pelican Bay State Prison – Crescent City, CA
Salinas Valley State Prison – Soledad, CA
San Quentin State Prison – San Quentin, CA

As part of the regular monitoring of the discipline process, the OIG has previously
criticized this practice, and the OIA responded by ending the San Quentin assignment,
and does not plan to assign a resident agent to CMC in San Luis Obispo. However, the
others have remained in place.
Routinely, resident agents have an office physically located within the prison they are
tasked with investigating. In all of the current assignments, the resident agent worked at
least part of their career, if not their entire career, at one of the institutions they now
“reside” at for work. While the OIG understands the department is attempting to remedy
a recruiting issue, the assignment of resident agents can lead to bias or the perception of
bias. In addition, the assignment of resident agents runs counter to the recently codified 30
Madrid mandate, which to facilitate contemporaneous oversight and transparency,
requires OIG staff be physically co-located with OIA staff.
Recent events at High Desert State Prison highlight the problems that assigning a resident
agent can cause, not only for the resident agent, but also for the friends and coworkers the
agent encounters. As described in a previous section, a special agent assigned to HDSP
was demoted after he released confidential information regarding multiple internal
investigations, including information regarding a pending criminal investigation. His
demotion caused him to be placed back at HDSP. Shortly thereafter, he was promoted.
This leaves the perception that he was being rewarded by HDSP management for his
actions as an OIA special agent, and his loyalty to HDSP.
Additionally, an officer from CCC was disciplined for receiving confidential information
from the resident agent pertaining to another employee’s internal investigation and then
failing to report that he had received the information. Staff from HDSP released
confidential information pertaining to the internal investigations of several other
employees.
30

PC Section 6133.

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On a separate but similar note, the OIA routinely assigns investigations to non-resident
agents at institutions where they recently worked. While special agents are required to
sign a conflict of interest form, disclosing any conflict in the cases they are assigned to
investigate, the Office of Internal Affairs assigns an overly narrow interpretation to the
concept of a “conflict of interest.” While OIA contends it can be valuable for a special
agent to be familiar with a prison (in particular, its processes, layout, etc.) when
conducting investigations, it is important that all possible conflicts be duly considered, as
an effective investigation and employee discipline process must be free from bias or the
perception of bias. OIA’s conflict form requires only a self-assessment by the assigned
agent with little or no additional scrutiny by a supervisor unless the agent indicates a
potential conflict.

R ECOMMENDATIONS T O CDCR
•

Revisit DOM Section 31140.14, and develop a procedure to ensure staff
completing allegation inquiries have received approved internal affairs
investigation training, prior to being designated and/or approved by CDCR’s OIA
or OIA investigators.

•

Require allegation inquiries be conducted only by staff who have received formal
internal affairs investigation training.

•

Ensure hiring authorities and managers reviewing allegation inquiry reports are
trained to recognize a complete, thorough, and adequate allegation inquiry report.

•

Develop an accountability process for ensuring hiring authorities are keeping
accurate and complete CDCR Form 2140, Internal Affairs Allegation Logs, in
accordance with DOM Section 31140.13.

•

Cease the practice of assigning resident agents.

•

Carefully review and consider conflict of interest forms completed by special
agents prior to assigning investigations, especially when contemplating assigning
investigations to special agents who formerly worked at the institution where the
misconduct allegations arose.

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FINDINGS AND RECOMMENDATIONS
FINDING 1 – ENTRENCHED CULTURE
There is evidence that a perception of insularity and indifference to inmates exists at High
Desert State Prison, exacerbated by the unique geographical isolation, the high stress
environment, and a labor organization that opposes oversight.

RECOMMENDATIONS TO CDCR
1.1 Infuse HDSP supervisory and management positions with culturally diverse staff
who have experience working in other institutions and do not have lifelong ties to
the community.
1.2 Consider rotating HDSP management staff to other institutions, similar to the
rotation required for CDCR headquarters peace officer staff.
1.3 Increase the frequency at which peer reviews are conducted at HDSP.
1.4 Revise the peer review tool to include follow-up measures and tests that better
assess areas that could indicate deep-seated issues, such as by adding PREA and
ADA compliance components.
1.5 Increase inmate programming, especially on the SNY facilities.
1.6 Ensure inmates housed in enhanced program facilities meet the EPF participation
criteria.
1.7 Ensure HDSP is following the DOM requirements related to staff in high stress
assignments.
1.8 Require HDSP seek approval from the CDCR Associate Director, prior to
extending staff in high stress assignments beyond the initial two years.
1.9 Seek out opportunities to partner with organizations, such as the US DOJ, to
conduct research and provide training to custody staff, starting at HDSP, on how
to recognize and address implicit bias.
1.10 Implement a mindfulness and wellness program that gives staff resiliency tools to
cope with working in a uniquely stressful environment.

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FINDING 2 – SEX OFFENDERS AND THE R SUFFIX
The R suffix has served as a bull’s-eye target on some inmates at HDSP and other
prisons, some of whom have never been convicted of a sex offense.

RECOMMENDATIONS TO CDCR
2.1 Develop a policy authorizing staff to access an inmate’s electronic record on a
need-to-know basis only. The policy should add admonishment language to
the SOMS login screen, advising against misuse, and the consequence thereof.
2.2 Develop a method of tracking and recording staff access to records in SOMS
and other inmate records, and periodically audit access history to identify
potential misuse.
2.3 Remove the R suffix information from the SOMS header, as any staff
specifically needing this information can find it on another screen.
2.4 Conduct an in-depth review of every form and document that currently
requires commitment offense information and R suffix notations, and remove
this requirement from all forms and documents where it no longer serves a
legitimate purpose.
2.5 Consider providing inmates with only hard copies of certain portions of nonconfidential documentation from SOMS or other inmate records, to exclude
commitment offenses, R suffix notations, and any other information that may
put an inmate at risk.

FINDING 3 – SENSITIVE NEEDS YARDS
Based upon this review and observations in prior OIG reports, the use of sensitive needs
yards merits a complete overhaul.

RECOMMENDATIONS TO CDCR
3.1 Address the growing violence on sensitive needs yards by:
a) developing formal policies and procedures related to SNY housing;
b) considering the development of separate SNY housing criteria for
vulnerable inmates at risk of assault;
c) transferring aggressors to some other type of housing;
d) re-examining the double cell policy for sensitive needs yards pursuant to
previous OIG recommendations,
e) requiring completion of a compatibility review, similar to the CDCR Form
1882-B, Administrative Segregation Unit/Security Housing Unit Double
Cell Review; and
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f) reviewing the process for transitioning inmates from single-cell designation
to double-cell status, pursuant to prior OIG recommendations.
3.2 Add more meaningful programs to sensitive needs yards, especially Level IV
SNYs such as HDSP’s Facility B, where programs have been historically
lacking.
3.3 Ensure that classification staff designating inmates as requiring SNY
placement, inform them that SNY yards are still violent, have programming
no different from GP yards, and once assigned to an SNY, it is very difficult
to ever return to a general population yard.
3.4 Require training for SNY staff in supervising vulnerable populations.
3.5 Require racial balance criteria for inmate program assignments in SNY
housing, at least at HDSP, similar to general population facilities, to overcome
the perception of racial bias.

FINDING 4 – INMATE APPEALS AND STAFF COMPLAINTS
The inmate appeals system at HDSP is not functioning adequately and the staff complaint
process is broken.

RECOMMENDATIONS TO CDCR
4.1 Create a formal policy that reflects the contents of the December 30, 2011,
memo titled: Secure Appeal Collection Sites and Related Matters, but require
appeals in lock boxes be retrieved by Appeals Office staff only.
4.2 Add a receipt feature to the CDCR Form 602, Inmate/Parolee Appeal, or
assign a log number to all appeals at the point of collection.
4.3 Immediately reiterate that initial appeal content is to be read by Appeals
Office staff only, until assigned out for response.
4.4 Provide HDSP staff with training relating to the processing and handling of
inmate property and hold officers accountable for failing to abide by the
relevant policies and procedures.
4.5 Require institutions to conduct a management review into an employee’s
performance and worksite when multiple staff complaints are filed by multiple
inmates against an individual employee.
4.6 Revisit DOM Section 31140.14, and develop a procedure to ensure staff
completing allegation inquiries have received approved internal affairs

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investigation training, prior to being designated and/or approved by CDCR’s
OIA or OIA investigators.
4.7 Require staff performing allegation inquiries into staff complaints receive
formal internal affairs investigation training prior to conducting allegation
inquiries.
4.8 Ensure hiring authorities and managers reviewing allegation inquiry reports
are trained to recognize complete, thorough, and adequate allegation inquiry
reports.
4.9 Develop an accountability process for ensuring hiring authorities are keeping
accurate and complete CDCR Form 2140, Internal Affairs Allegation Logs, in
accordance with DOM Section 31140.13, which requires each allegation of
employee misconduct be logged, regardless of whether the allegation is
referred for investigation.
4.10 Renegotiate Section 9.09 of the Bargaining Unit 6 MOU to treat inmate
appeals in the same manner as any other allegation of staff misconduct.
4.11 Remedy the inability of inmates in ASU or on a modified program to
personally place their appeal into a lock box by mandating Appeals Office
staff personally retrieve the appeal from the inmates’ cells or instituting some
form of secure mobile collection process.
4.12 Dispatch staff from the Appeals Office to conduct an in-depth audit of
HDSP’s appeal process, provide any remedial training necessary, and report
back to CDCR administrators any policy or procedure deficiencies revealed
by a review of HDSP inmate appeals, such as property issues and the handling
of staff complaints.

FINDING 5 – USE OF FORCE INCIDENTS
There are statistical trends, continued complaints, and recent misconduct allegations that
cause alarm about the use of force at HDSP.

RECOMMENDATIONS TO CDCR
5.1 Immediately install cameras in all inmate areas, including, but not limited to,
the exercise yards, rotundas, building dayrooms, patios, and program offices
of HDSP.
5.2 Implement a pilot program in at least one building on HDSP’s Level IV SNY
facility, requiring custody staff to wear body cameras, similar to the pilot
conducted at Wisconsin’s Waupun Correctional Institution. Ensure the body
cameras are equipped with GPS geotagging technology. Collect, compare, and
report the resulting incident, disciplinary, and other relevant data for the

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buildings with body cameras and the similar buildings without body cameras,
for possible statewide pilot program expansion.
5.3 Ensure that HDSP custody supervisors are scrutinizing all incidents where
inmates receive serious injuries, and hold accountable officers who fail to
timely respond to incidents and fail to use force when appropriate to stop
potential deadly attacks.
5.4 Consider using GPS or RFID type technology to document where within an
institution an officer is located.

FINDING 6 – ARMSTRONG REMEDIAL PLAN – ADA INMATES
In light of the Armstrong federal court’s ongoing monitoring, the OIG expressly refrains
from making findings in this area, and has reserved comment to those areas where OIG’s
review has supported the Plaintiffs’ last review and the department’s inadequate
responses. We make the following recommendations in light of these comments.

RECOMMENDATIONS TO CDCR
6.1 Move the DPP inmates to another Armstrong-designated institution, if paths
of travel and accessibility cannot be immediately fixed at HDSP.
6.2 Revise the ADA tab in the SOMS computer system to:
a) Better capture details of an ADA inmate’s accommodation needs. For
instance, instead of only stating that an inmate has an accommodation for
“Shoes,” insert a detailed description, or even a picture of the shoes.
b) Include a place to record the doctor’s name.
c) When applicable, describe the specific restraint accommodation needed,
such as “waist restraint.”
6.3 Train staff on Armstrong Remedial Plan and ADA requirements, document
the training, and when new violations occur, hold both the offending officers
and their supervisors accountable for failure to follow or enforce the training.

FINDING 7 – INTERNAL AFFAIRS INVESTIGATIONS
The use of resident agents is a poor practice and should be discontinued, especially at
HDSP in light of the issues that arose from the placement of a resident agent at that
institution. Additionally, the processes in place for allegation inquiries at HDSP are
inadequate, and could be improved statewide. The OIG is monitoring several misconduct
investigations that, but for this review may not have been opened or investigated to the
broadest extent appropriate.
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RECOMMENDATIONS TO CDCR
7.1 Revisit DOM Section 31140.14, and develop a procedure to ensure staff
completing allegation inquiries have received approved internal affairs
investigation training, prior to being designated and/or approved by CDCR’s
OIA or OIA investigators.
7.2 Require allegation inquiries be conducted only by staff who have received
formal internal affairs investigation training.
7.3 Ensure hiring authorities and managers reviewing allegation inquiry reports
are trained to recognize a complete, thorough, and adequate allegation inquiry
report.
7.4 Develop an accountability process for ensuring hiring authorities are keeping
accurate and complete CDCR Form 2140, Internal Affairs Allegation Logs, in
accordance with DOM Section 31140.13.
7.5 Cease the practice of assigning resident agents.
7.6 Carefully review and consider conflict of interest forms completed by special
agents prior to assigning investigations, especially when contemplating
assigning investigations to special agents who formerly worked at the
institution where the misconduct allegations arose.

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CONCLUSION
First, we want to note that there are dedicated, hardworking, and conscientious staff that
make up the vast majority of the workforce at HDSP. They come to work every day and
do the best they can in a very difficult job. However, as a famous quote states:
“All that is necessary for the triumph of evil is that good men do nothing.”
-Edmund Burke
Many of the specific instances of misconduct and even some of the pervasive indifferent
treatment of inmates can be narrowed down to a small percentage of active participants,
many of whom are currently under investigation. But how is it that they have been able to
continue this conduct without interference by others or management? How is it that the
sister institution CCC does not have the same problems and complaints? The answers
may lie in the very design and mission of HDSP and the environment in which it has
been placed.
HDSP has a myriad of missions and houses the highest security level of inmates. The
same is not true at CCC. Officers at HDSP are constantly on high alert, and enter the
prison with an “us versus them” mindset. This translates into a culture where “if you
aren’t for us, you’re against us.” Add to that a labor organization that values the
brotherhood of silence over the professionalism of its members, and you add another
level of legitimacy to a negative culture. The irony is that this very culture endangers the
staff working at HDSP as much as anything else. When you deprive inmates of
procedural justice, and there is no recourse for mistreatment because the appeals process
is broken and there is a perception that staff misconduct is not addressed, there should be
no surprise that violence erupts.
Unlike any other locale, HDSP staff live in a true “prison town” where they cannot
disassociate from the job. The pressure to conform to the prevailing norm is tremendous.
One of the differences in a lower security prison such as CCC is that staff see the inmates
trying to make a difference, and “deserving” of a chance to do so. There is less violence,
more programs, less stress, and therefore not the same negative mentality.
The department could change the population of HDSP, and concede that the other forces
at work prevent it from ever curing its dysfunction in the current mode. That would be
the most drastic of solutions.
However, with the support of the CDCR Administration, and the right leadership from
management and in the ranks, HDSP can change these perceptions, if they choose to do
so. The department can implement recommendations from this review, weed out the
problem individuals, and provide hope for the future.
The department is now being presented with yet another opportunity to fix the problems
at HDSP that have plagued the institution for over a decade. Otherwise, this review will
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have been for naught and another review will almost assuredly follow in the very near
future.
To their credit, CDCR leadership had staff conduct a peer review, which was a start. The
department has now instituted additional Armstrong training at HDSP, as well as a
comprehensive management review and training plan, to be led in December and January
by the newly placed acting warden. The OIG has met with CDCR’s OIA to discuss the
use of resident agents, and while CDCR has not agreed to discontinue their use, OIG’s
concerns were heard, and the department agreed in theory that hiring agents from the
prisons they are assigned to is not a best practice. The OIA is considering steps to
mitigate bias, such as moving agents to offices outside the institution. But even that
measure will not cure the problems with using a resident agent at HDSP.
Nonetheless, these recent efforts signal that a desire for change exists within CDCR
leadership. The OIG has a sincere hope that they will be successful.

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APPENDICES
Appendix A– Senate Rules Committee Authorization Letter……………………..……..64
Appendix B– CDCR Memorandum: Enhanced Program Facility Institutions……..……66
Appendix C– CDCR Memorandum: Secure Appeal Collection Sites and Related
Matters.........................................................................................................69
Appendix D– California Department of Corrections and Rehabilitation Zero Tolerance
Regarding the Code of Silence…………….……………………………...71
Appendix E‒ Peer Review High Desert State Prison……………………………………72
Appendix F‒ Police Racial Violence: Lessons From Social Psychology………….…….89
Appendix G‒ Center for Mindfulness in Corrections………………………….…...…..105
Appendix H‒ Average Number of Incidents per 100 Inmates, June 2014-June 2015....107
Appendix I‒ Average Number of Inmate Disciplinary Actions per 100 Inmates June
2014-June 2015…………...…..………………………………………..…108
Appendix J‒ WCI Taser Body Camera Pilot………………….……………..…………109

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APPENDIX A – SENATE RULES COMMITTEE AUTHORIZATION LETTER

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APPENDIX B – CDCR MEMORANDUM: ENHANCED PROGRAM FACILITY INSTITUTIONS

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APPENDIX D –CDCR ZERO TOLERANCE REGARDING THE CODE OF SILENCE

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APPENDIX F‒ POLICE RACIAL VIOLENCE: LESSONS FROM SOCIAL PSYCHOLOGY

POLICE RACIAL VIOLENCE:
LESSONS FROM SOCIAL PSYCHOLOGY
L. Song Richardson*
INTRODUCTION
The recent rash of police killing unarmed black men has brought national
attention to the persistent problem of policing and racial violence. These
cases include the well-known and highly controversial death of Michael
Brown in Ferguson, Missouri,1 as well as the deaths of twelve-year-old
Tamir Rice in Cleveland, Ohio;2 Eric Garner in Staten Island, New York;3
John Crawford III in Beavercreek, Ohio;4 Ezell Ford in Los Angeles,
California;5 Dante Parker in San Bernardino County, California;6 and
Vonderrit D. Myers Jr. in St. Louis, Missouri.7 Data reported to the FBI
indicate that white police officers killed black citizens almost twice a week

* Professor, The University of California, Irvine School of Law. J.D., Yale Law School;
A.B., Harvard College. I wish to thank Professors Kimani Paul-Emile and Robin Lenhardt
for the opportunity to participate in this symposium entitled Critical Race Theory and
Empirical Methods Conference held at Fordham University School of Law. I am also
appreciative of the excellent research assistance provided by Sierra Nelson and Ariela
Rutkin-Becker. For an overview of the symposium, see Kimani Paul-Emile, Foreword:
Critical Race Theory and Empirical Methods Conference, 83 FORDHAM L. REV. 2953 (2015).
1. See, e.g., Jonathan Cohn, Darren Wilson Walks: No Indictment for Michael Brown’s
Killer, NEW REPUBLIC (Nov. 24, 2014), http://www.newrepublic.com/article/120395/
ferguson-grand-jury-makes-issues-no-charges-officer-wilson.
2. See, e.g., Emma G. Fitzsimmons, Video Shows Cleveland Officer Shot Boy in 2
Seconds, N.Y. TIMES, Nov. 27, 2014, at A25, available at http://www.nytimes.com/2014/
11/27/us/video-shows-cleveland-officer-shot-tamir-rice-2-seconds-after-pulling-up-next-tohim.html.
3. See, e.g., J. David Goodman & Al Baker, Wave of Protests After Grand Jury Doesn’t
Indict Officer in Eric Garner Chokehold Case, N.Y. TIMES (Dec. 3, 2014),
http://www.nytimes.com/2014/12/04/nyregion/grand-jury-said-to-bring-no-charges-instaten-island-chokehold-death-of-eric-garner.html.
4. Catherine E. Shoichet & Nick Valencia, Cops Killed Man at Walmart, Then
Interrogated Girlfriend, CNN (Dec. 16, 2014, 10:28 PM), http://www.cnn.com/
2014/12/16/justice/walmart-shooting-john-crawford/.
5. Jennifer Medina, Man Is Shot and Killed by the Police in California, N.Y. TIMES,
Aug. 14, 2014, at A16.
6. Philip Caulfield, Father of 5 Dies After Getting Tased by Police During Attempted
Burglary Arrest, N.Y. DAILY NEWS (Aug. 15, 2014), http://www.nydailynews.com/
news/national/father-5-dies-tased-police-arrest-article-1.1904577.
7. Alan Blinder, New Outcry Unfolds After St. Louis Officer Kills Black Teenager,
N.Y. TIMES, Oct. 10, 2014, at A18.

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between 2005 and 2012.8 This number is underinclusive because the FBI
database is based on self-reports by departments that choose to participate
and only includes deaths that the police conclude are justifiable.9
Many accounts attempt to explain these instances of racial violence at the
hands of the police, ranging from arguments that the police acted justifiably
to arguments likening these killings to Jim Crow lynchings.10 Certainly, it
is tempting to blame racial violence on either the racial animus of officers
or the purportedly threatening behaviors of victims because it simplifies the
problem; either the individual officer or citizen is at fault.
However, reducing the problem of racial violence to the individual
police-citizen interaction at issue obscures how current policing practices
and culture entrench racial subordination and, thus, racial violence. This is
because as a result of our nation’s sordid racial history, white supremacy
and racial subordination have become embedded not only within social
systems and institutions but also within our minds. As a result, unless
corrective structural and institutional interventions are made, racial violence
is inevitable regardless of whether officers have malicious racial motives or
citizens engage in objectively threatening behaviors.
This Essay proceeds in three parts. Part I discusses how unconscious
racial biases and implicit white favoritism can result in racial disparities in
police violence. Part II moves beyond unconscious biases and focuses
instead on how the personal insecurities of police officers in the form of
stereotype threat and masculinity threat also can lead to racial violence.
Finally, Part III argues that when considered in combination, these
psychological processes powerfully demonstrate why racial violence is
inevitable and overdetermined given current policing practices and culture,
even when conscious racial animus is absent. Part III concludes by
discussing the need to implement institutional and structural changes to
reduce instances of racial violence.
I. IMPLICIT RACIAL BIAS AND IMPLICIT WHITE FAVORITISM
Both implicit racial bias and implicit white favoritism are consequential
when it comes to racial violence, but in opposite ways. Implicit racial
biases typically refer to unconscious anti-black bias in the form of negative
stereotypes (beliefs) and attitudes (feelings) that are widely held, can
conflict with conscious attitudes, and can predict a subset of real world
behaviors. For instance, implicit racial biases can influence whether black
8. Kevin Johnson et al., Local Police Involved in 400 Killings Per Year, USA TODAY
(Aug. 15, 2014), http://www.usatoday.com/story/news/nation/2014/08/14/police-killingsdata/14060357/.
9. Only 750 of the approximately 17,000 law enforcement agencies in the United States
participate. Id. Unfortunately, this is the only national database that collects data on police
use of deadly force. Id. (quoting Geoff Alpert, a criminologist from the University of South
Carolina who studies police use of deadly force).
10. Isabel Wilkerson, Mike Brown’s Shooting and Jim Crow Lynchings Have Too Much
in Common.
It’s Time for America to Own Up, GUARDIAN (Aug. 25, 2014),
http://www.theguardian.com/commentisfree/2014/aug/25/mike-brown-shooting-jim-crowlynchings-in-common.

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individuals receive callback interviews11 and life-saving medical
procedures,12 as well as whether individuals exhibit nonverbal discomfort
when interacting with non-whites.13 Decades of research demonstrate that
most Americans are unconsciously biased against black individuals.14
Two specific types of implicit racial biases are consequential when it
comes to racial violence. First is the implicit association between blacks
and criminality.15 This unconscious association has led officers to
misidentify blacks with more stereotypically black features such as dark
skin, full lips, and wide noses as criminal suspects,16 to engage in
unconscious racial profiling,17 and to shoot more stereotypical-looking
black suspects more quickly than others in computer simulations.18
More recently, a second type of unconscious anti-black bias has proven
consequential to racial violence. Implicit dehumanization refers to the
tendency of individuals to unconsciously associate blacks with apes.
Recent studies demonstrate that implicit dehumanization predicts police
violence against black juveniles.19 In one of these studies, subjects who
had been subliminally primed with images of apes were more likely to find
a vicious beating of a black suspect to be justified.20 Similar effects did not
occur when the victim was white or when individuals were not primed.
11. See Dan-Olof Rooth, Implicit Discrimination in Hiring: Real World Evidence 1, 4–5
(Inst. for the Study of Labor, Discussion Paper No. 2764, 2007), available at http://dnb.info/98812002X/34 (discussing the difference in receiving callback job interviews
between applicants with Arab or Muslim names and applicants with Swedish names); see
also Marianne Bertrand & Sendhil Mullainathan, Are Emily and Greg More Employable
Than Lakisha and Jamal? A Field Experiment on Labor Market Discrimination, 94 AM.
ECON. REV. 991, 998 (2004) (demonstrating that job applicants with white-sounding names
such as Emily or Greg were 50 percent more likely to receive callback job interviews in
Boston and 49 percent more likely in Chicago than applicants with black-sounding names
like Jamal); Devah Pager et al., Discrimination in a Low-Wage Labor Market: A Field
Experiment, 74 AM. SOC. REV 777, 788 (2009).
12. See Alexander R. Green et al., Implicit Bias Among Physicians and Its Prediction of
Thrombolysis Decisions for Black and White Patients, 22 J. GEN. INTERNAL MED. 1231
(2007).
13. See generally John E. Dovodio et al., Why Can’t We Just Get Along? Interpersonal
Biases and Interracial Distrust, 8 CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOL. 88
(2002).
14. See generally Kristin Lane et al., Implicit Social Cognition and Law, 3 ANN. REV. L.
& SOC. SCI. 427 (2007).
15. For an in-depth discussion of how this stereotype can influence judgments of
criminality, see L. Song Richardson & Phillip Atiba Goff, Self-Defense and the Suspicion
Heuristic, 98 IOWA L. REV. 293 (2012).
16. Jennifer L. Eberhardt et al., Seeing Black: Race, Crime, and Visual Processing, 87
J. PERSONALITY & SOC. PSYCHOL. 876, 876 (2004).
17. See Sophie Trawalter et al., Attending to Threat: Race-Based Patterns of Selective
Attention, 44 J. EXPERIMENTAL SOC. PSYCHOL. 1322, 1322 (2008); Eberhardt et al., supra
note 16, at 890.
18. See Kimberly Barsamian Kahn & Paul G. Davies, Differentially Dangerous?
Phenotypic Racial Stereotypicality Increases Implicit Bias Among Ingroup and Outgroup
Members, 14 GROUP PROCESSES & INTERGROUP REL. 569, 573 (2011).
19. See generally Phillip Atiba Goff et al., Not Yet Human: Implicit Knowledge,
Historical Dehumanization, and Contemporary Consequences, 94 J. PERSONALITY & SOC.
PSYCHOL. 292 (2008).
20. See id. at 292–97.

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Additionally, this study found that implicit dehumanization influences real
world behaviors. The researchers discovered that the more closely police
officers unconsciously associated black youths with apes, the more likely
they were to have used force against black children throughout the course of
their careers.21
The recognition that implicit racial biases can cause racially disparate
effects, even in the absence of conscious bias, is becoming increasingly
commonplace in mainstream discussions of police violence.22 This science
demonstrates that even when people are acting in identical ways, implicit
racial bias places black citizens more at risk of mistaken judgments of
danger and criminality. As a result, they are more likely to be shot, more
likely to be dehumanized, and more likely to be seen as deserving of an
officer’s use of force.23
While significant attention has been paid to implicit anti-black racial
bias, a sister concept, implicit white favoritism, has received almost no
attention in the legal literature. I am only aware of one law review article
on the subject.24 In that article, Professors Robert Smith, Justin Levinson,
and Zoë Robinson explain that implicit white favoritism is “the automatic
association of positive stereotypes and attitudes with members of a favored
group, leading to preferential treatment for persons of that group. In the
context of the American criminal justice system, implicit favoritism is white
favoritism.”25 While the concept of implicit white favoritism is new,
critical race scholars have long identified white supremacy as a central
building block of racial subordination.26 Now, social psychological
evidence provides empirical support for the theory.
Considering implicit white favoritism in tandem with implicit racial bias
is important because it illuminates that racial disparities would remain in
the context of racial violence even if all implicit anti-black biases were
eliminated.27 As Professor Smith and his colleagues explain, “Removing
out-group derogation is not the same as being race-neutral.”28 For instance,
one study found that when subjects were primed with white faces, they
were slower to identify weapons than when they had not been primed with
21. See Phillip Atiba Goff et al., The Essence of Innocence: Consequences of
Dehumanizing Black Children, 106 J. PERSONALITY & SOC. PSYCHOL. 526, 528–29 (2014).
22. See Chris Mooney, The Science of Why Cops Shoot Young Black Men, MOTHER
JONES (Dec. 1, 2014), http://www.motherjones.com/politics/2014/11/science-of-racismprejudice.
23. For a discussion of a recent study demonstrating this, see L. Song Richardson &
Phillip Atiba Goff, Interrogating Racial Violence, 12 OHIO ST. J. CRIM. L. 115, 138–43
(2014).
24. Robert J. Smith et al., Bias in the Shadows of Criminal Law: The Problem of
Implicit White Favoritism, 66 ALA. L. REV. (forthcoming 2015) (on file with author).
25. Id. (manuscript at 4).
26. Critical race scholars have long discussed white supremacy. See, e.g., Derrick Bell,
Racial Realism, 24 CONN. L. REV. 363, 363–379 (1998); DERRICK BELL, RACE, RACISM AND
AMERICAN LAW (6th ed. 2008); DERRICK BELL, AND WE ARE NOT SAVED: THE ELUSIVE
QUEST FOR RACIAL JUSTICE (1989).
27. See Smith et al., supra note 24 (manuscript at 4) (noting that “[e]ven if we could
eliminate [implicit anti-black bias], . . . racial disparities would persist.”).
28. Id. (manuscript at 28).

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any faces at all.29 Thus, while black men are associated with violence and
criminality, facilitating racial violence against them, white men “are
automatically and cognitively disassociated with violence.”30 In other
words, being white protects people against racial violence. It is simply
cognitively more taxing to associate whites with criminality.
Both implicit racial bias and implicit white favoritism together highlight
why attempting to determine whether officers are bigots or reasonably felt
threatened by the actions of victims does little to explain or address the
problem of racial violence. These two processes together demonstrate that
black men are at greater risk of racial violence at the hands of the police
even when the officer confronting them is consciously egalitarian, and even
if black men are acting identically to white men in the same situation.
Once implicit biases are activated—and simply thinking about crime is
sufficient to activate them31—officers’ attention will be drawn to black men
more readily than white men, even if they are acting identically and even if
officers are not engaged in conscious racial profiling. Once black men are
under close police scrutiny, unconscious racial criminality can influence the
way an officer interprets their ambiguous behaviors, causing the officer to
be more likely to interpret their actions as being consistent with criminality
even as identical behaviors engaged in by young white men would not
arouse suspicion.32 In fact, the unconscious association between blacks and
criminality can explain why officers are primed to see a weapon or assume
that one exists when black men reach into their pockets or the glove
compartment of a car. On the other hand, implicit white favoritism
illuminates why unarmed white men are significantly less likely to be shot
in similar circumstances.
Implicit white favoritism explains why being white helps inoculate white
men from this series of events. It is more difficult to view them as criminal.
Unlike with black men, thinking about crime draws attention away from
whites.33 As Professor Smith and his colleagues write, “[S]eeing white
automatically means seeing positive, law abiding behavior.”34 In fact, in
one study, Professor Levinson found that subjects reading about an
aggressive white defendant recalled fewer aggressive facts when relating
the story than when the defendant was black.35 Seeing white also makes it
more difficult to identify weapons.36 Thus, asking whether officers feared
for their safety when confronting an individual does not address the fact
that white men acting in identical ways would not trigger the same violent
reaction. This is why focusing solely on the individual interaction between
29. Id. (manuscript at 32) (citation omitted).
30. Id. (emphasis added).
31. See Eberhardt et al., supra note 16, at 883.
32. For an extended discussion, see L. Song Richardson, Arrest Efficiency and the
Fourth Amendment, 95 MINN. L. REV. 2035, 2045–48, 2052–53 (2011).
33. See Smith et al., supra note 24 (manuscript at 47).
34. Id.
35. Id. (manuscript at 21–22) (citing Justin D. Levinson, Forgotten Racial Equality:
Implicit Bias, Decisionmaking, and Misremembering, 57 DUKE L.J. 345 (2007)).
36. Id. (manuscript at 36, 48).

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officers and victims merely entrenches racial disparities in police use of
force. Rather, the inquiry must be structural and institutional.
II. SELF-THREATS
Thus far, this Essay has focused on how police officers’ unconscious
perceptions can facilitate or inhibit racial violence. This part examines a
different question, namely, how do officers’ perceptions of themselves
influence their use of force? Recent psychological evidence suggests that
the self-directed insecurities of officers also can enable racial violence.
This part analyzes two self-threats in particular, stereotype threat and
masculinity threat.
A. Stereotype Threat
Stereotype threat refers to the anxiety that occurs when a person is
concerned about confirming a negative stereotype about his or her social
group.37 I have discussed stereotype threat in depth elsewhere but provide a
brief summary here.38 Stereotype threat affects performance because
concerns about being negatively stereotyped redirect cognitive resources
away from the task at hand, leading to deficient performances.39
Importantly, people do not need to believe or endorse the stereotype in
order to be influenced by stereotype threat. Rather, it occurs whenever
individuals care about their performance on a given task, are aware of the
negative stereotype, and are concerned that failure or a deficient
performance will confirm the negative stereotype.40

37. See Claude M. Steele, A Threat in the Air: How Stereotypes Shape Intellectual
Identity and Performance, 52 AM. PSYCHOL. 613 (1997); Claude M. Steele & Joshua
Aronson, Stereotype Threat and the Intellectual Test Performance of African Americans, 69
J. PERSONALITY & SOC. PSYCHOL. 797 (1995).
38. See Richardson & Goff, supra note 23, at 124–28.
39. See generally Jennifer K. Bosson et al., When Saying and Doing Diverge: The
Effects of Stereotype Threat on Self-Reported Versus Non-Verbal Anxiety, 40 J.
EXPERIMENTAL SOC. PSYCHOL. 247 (2004); Laurie T. O’Brien & Christian S. Crandall,
Stereotype Threat and Arousal: Effects on Women’s Math Performance, 29 PERSONALITY &
SOC. PSYCHOL. BULL. 782 (2003); Sian L. Beilock et al., On the Causal Mechanisms of
Stereotype Threat: Can Skills That Don’t Rely Heavily on Working Memory Still Be
Threatened?, 32 PERSONALITY SOC. PSYCHOL. BULL. 1059 (2006); Jim Blascovich et al.,
African Americans and High Blood Pressure: The Role of Stereotype Threat, 12 PSYCHOL.
SCI. 225 (2001); Phillip Atiba Goff et al., The Space Between Us: Stereotype Threat and
Distance in Interracial Contexts, 94 J. PERSONALITY & SOC. PSYCHOL. 91 (2008); Brenda
Major & Laurie T. O’Brien, The Social Psychology of Stigma, 56 ANN. REV. PSYCHOL. 393
(2005); Wendy Berry Mendes et al., Challenge and Threat During Social Interactions with
White and Black Men, 28 PERSONALITY & SOC. PSYCHOL. BULL. 939 (2002); Wendy Berry
Mendes et al., How Attributional Ambiguity Shapes Physiological and Emotional Responses
to Social Rejection and Acceptance, 94 J. PERSONALITY & SOC. PSYCHOL. 278 (2008); Toni
Schmader & Michael Johns, Converging Evidence That Stereotype Threat Reduces Working
Memory Capacity, 85 J. PERSONALITY & SOC. PSYCHOL. 440 (2003).
40. See generally Steele & Aronson, supra note 37.

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In one study demonstrating the influence of stereotype threat, white men
who had high SAT math scores were asked to take a difficult math test.41
In the stereotype threat condition, they were told that the test would
evaluate mathematical proficiency.42 They also were given information
suggesting that Asians typically outperformed other students.43 In the
control condition, they were only told that the test evaluated mathematical
ability without any mention of Asian student performance.44 The subjects
in the threat condition performed significantly worse than the subjects in the
control group.45 In another experiment, researchers found that when white
men believed that an athletic skills task required athletic intelligence rather
than natural sports ability, they performed better than when the opposite
was true.46
Across a number of studies, researchers have discovered that dominant
group members’ concerns with being negatively stereotyped as racist can
work to the detriment of subordinated groups. In one study, researchers had
white teachers read and give written feedback on an essay purportedly
written by students.47 The researchers found that when white teachers
experienced stereotype threat, their fear of being judged as racist caused
them to give falsely positive feedback when they believed the essay was
written by black students but not when they believed the essay was written
by white students. In a similar study, researchers found that when white
subjects feared they would appear racially biased, they were less likely to
warn black students that their workload might be unmanageable while not
feeling similarly constrained with white students.48
Recent work by social psychologist Phillip Atiba Goff and his colleagues
suggests that the fear of being evaluated as racist can also result in racial
violence. In one study, ninety-nine members of the San Jose Police
Department completed measures of their explicit and implicit racial
attitudes as well as a measure of how concerned they were with appearing
racist.49 The researchers then obtained a copy of each officer’s use of force
history from the previous two years to determine whether there was any
relationship between the use of force and the officer’s psychological

41. See Joshua Aronson et al., When White Men Can’t Do Math: Necessary and
Sufficient Factors in Stereotype Threat, 35 J. EXPERIMENTAL SOC. PSYCHOL. 29 (1999).
42. Id. at 36–37.
43. Id.
44. Id. at 37.
45. Id. at 37–38.
46. See Jeff Stone et al., Stereotype Threat Effects on Black and White Athletic
Performance, 77 J. PERSONALITY & SOC. PSYCHOL. 1213 (1999).
47. See Kent D. Harber et al., The Positive Feedback Bias As a Response to Self-Image
Threat, 49 BRIT. J. SOC. PSYCHOL. 207, 209 (2010).
48. See Jennifer Randall Crosby & Benoît Monin, Failure to Warn: How Student Race
Affects Warnings of Potential Academic Difficulty, 43 J. EXPERIMENTAL SOC. PSYCHOL. 663,
665–66 (2007).
49. See PHILLIP ATIBA GOFF ET AL., PROTECTING EQUITY: THE CONSORTIUM FOR POLICE
LEADERSHIP IN EQUITY ON THE SAN JOSE POLICE DEPARTMENT 3–4 (2012) [hereinafter SAN
JOSE REPORT].

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profile.50 Surprisingly, the researchers did not find any relationship
between explicit and implicit racial bias and the use of force.51 However,
they did find an association between stereotype threat and the use of force.
Higher levels of stereotype threat were associated with the greater use of
force against black suspects relative to other racial groups, both in the lab
and in the real world.52 Goff also did not find significant differences
between black and white officers in the level of stereotype threat they
experienced.53
It is tempting to explain this counterintuitive result by suggesting that
officers who have high levels of stereotype threat are also aversive racists.
Aversive racists are individuals who are consciously egalitarian but
unconsciously biased.54 However, if this were the case, then we would
expect to see a relationship between unconscious bias and stereotype threat.
Yet, this relationship did not exist.
It is more likely that this response is tied to legitimacy and how officers
are trained to respond to safety concerns. In his important work, Tom Tyler
has demonstrated that subordinates are more willing to voluntarily defer to
authorities and to follow their rules when those authorities are perceived to
be trustworthy and legitimate.55 Thus, legitimacy reduces the need to rely
upon coercive force to obtain compliance.56 While this focus on how
subordinate groups judge the legitimacy of authorities is important, new
evidence demonstrates that it is equally critical to attend to how dominant
groups understand their own legitimacy.
In a recent study, Goff and his team examined whether officers’ concerns
about legitimacy would influence their sense of safety and anxiety.57 One
hundred fourteen officers from two police departments participated in the
Officers’ legitimacy judgments were assessed along two
study.58
dimensions: whether they viewed their actions as legitimate and their
understanding of how others perceived their legitimacy.59
50. Id. at 4.
51. Id. at 11.
52. Id.
53. Id. at 5. As Goff notes, this could be attributed to either the small sample size of
non-white officers. Id. Fifty-three percent of the officers were white, 28 percent were
Hispanic, 6 percent were black and 6 percent were Asian, respectively. Id. at 4. It also could
be related to concerns white officers may have had with admitting to a fear of being judged
to be racist. Id. at 5. However, he also observed that non-white officers frequently
mentioned occasions when citizens of the same race accused them of racism. Id.
54. Leanne S. Son Hing et al., Exploring the Discrepancy Between Implicit and Explicit
Prejudice: A Test of Aversive Racism Theory, in SOCIAL MOTIVATION: CONSCIOUS AND
UNCONSCIOUS PROCESSES 274–75 (Joseph P. Forgas et al. eds., 2005).
55. Tom R. Tyler, Trust and Law Abidingness: A Proactive Model of Social Regulation,
81 B.U. L. REV. 361, 386 (2001); see also TOM R. TYLER & YUEN J. HUO, TRUST IN THE
LAW: ENCOURAGING PUBLIC COOPERATION WITH THE POLICE AND COURTS 49–96 (2002).
56. See Tyler, supra note 55, at 386; see also TOM R. TYLER, WHY PEOPLE OBEY THE
LAW 4, 8 (2006).
57. See Phillip Atiba Goff et al., Illegitimacy Is Dangerous: How Authorities
Experience and React to Illegitimacy, 4 PSYCHOL. 340, 341 (2013).
58. Id. at 342.
59. Id. at 340.

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To examine both of these aspects of legitimacy, the researchers asked
officers about a controversial policy that required them to enforce federal
immigration laws by sometimes stopping individuals suspected of being
undocumented and requesting proof of lawful immigration status.60
Officers were asked about their own perceptions of the policy.61
Additionally, because much of the debate surrounding this policy centered
on the question of whether officers would disproportionately stop Latino
residents, they were asked whether they believed the Latino community
would respect them while they enforced the policy.62 The authors used
respect as a proxy for legitimacy.63 The researchers also examined whether
these legitimacy judgments would influence how anxious and how safe
officers would feel when approaching either white or Latino suspects on the
street to enforce the policy.64 The results demonstrated that when officers
perceived that enforcing the policy would cause Latino individuals to lose
respect for them, they not only experienced anxiety but also expressed
concern for their safety when imagining future encounters with Latinos.65
This study illuminates one reason why stereotype threat can cause
officers to more readily use force against black suspects. Officers who
believe black citizens will evaluate them as racist also likely suspect that
those same citizens do not respect them and do not view them as legitimate.
As the Goff study revealed, these anxieties can translate into concerns for
their safety when confronting black citizens.66
When confronted with potentially threatening situations, Professor Frank
Rudy Cooper has observed that officers are trained to perform “command
presence” which involves “tak[ing] charge of a situation [and] projecting an
aura of confidence and decisiveness. It is justified by the need to control
dangerous suspects.”67 Officers who anticipate a dangerous situation based
on their experience of stereotype threat may enact command presence when
it is unnecessary. They may interpret the ambiguous behaviors of black
suspects as dangerous and threatening given not only implicit racial biases
but also their expectations that the situation is potentially dangerous.
However, this command and control approach may backfire. As Professor
Tom Tyler observes:
[B]y approaching people from a dominance perspective, police officers
encourage resistance and defiance, create hostility, and increase the
likelihood that confrontations will escalate into struggles over dominance
60. Id. at 342.
61. Id.
62. Id.
63. Id.
64. Id.
65. Id. at 343.
66. Id. at 341–42.
67. Frank Rudy Cooper, “Who’s the Man?”: Masculinities Studies, Terry Stops, and
Police Training, 18 COLUM. J. GENDER & L. 671, 674 (2009); see also Geoffrey P. Alpert,
Roger G. Dunham & John M. MacDonald, Interactive Police-Citizen Encounters That Result
in Force, 7 POLICE Q. 475, 476 (2004) (explaining the difference between “dominating
force” and “accommodating force”).

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that are based on force. The police may begin a spiral of conflict that
increases the risks of harm for both the police and for the public.68

Thus, this series of events can explain why officers are more likely to use
force against black citizens as a result of stereotype threat.
Note, however, that the same concerns do not arise in dealings with white
citizens. First, there is no worry about stereotype threat, here defined as the
fear of being evaluated as racist. Second, because of implicit favoritism,
more evidence of danger will be required before their ambiguous actions
generate safety concerns. Hence, officers are unlikely to enact command
presence too early, thus not triggering the cascade of conflict that leads to
the use of force.
B. Masculinity Threat
Another self-threat that can lead to racial violence is masculinity threat.
Masculinity threat refers to the fear of being perceived as insufficiently
masculine. I have discussed masculinity threat in depth elsewhere.69 In
summary, what it means to be masculine is socially constructed and thus,
how people perform their masculine identity depends upon the social
context. For men, maintaining their masculine identity often feels
precarious because it is not perceived “as a developmental guarantee, but as
a status that must be earned.”70 Thus, masculinity threat is pervasive
among men. Men often respond with action to prove their masculinity
when they feel that it is under threat. Sometimes, this gender performance
takes the form of violence, especially in hypermasculine environments
where exaggerated displays of physical strength and aggression are
glorified and rewarded as a means of demonstrating and maintaining one’s
masculine identity.71
A recent study demonstrated that police officers’ level of masculinity
threat predicts their use of force against black men.72 The researchers
found that masculinity threat predicted whether officers had used force
against black men, relative to men of other races, in the real world.73 The
use of force against black suspects was not correlated with either explicit or
implicit racial bias.74
68. Tyler, supra note 55, at 369 (citations omitted).
69. See Richardson & Goff, supra note 23, at 128–31.
70. Johnathan R. Weaver et al., The Proof Is in the Punch: Gender Differences in
Perceptions of Action and Aggression As Components of Manhood, 62 SEX ROLES 241, 242
(2010) (citation omitted); see also Joseph A. Vandello et al., Precarious Manhood, 95 J.
PERSONALITY & SOC. PSYCHOL. 1325, 1335 (2008) (finding that “manhood is seen as more of
a social accomplishment that can be lost and therefore must be defended with active
demonstrations of manliness”).
71. Angela P. Harris, Gender, Violence, Race, and Criminal Justice, 52 STAN. L. REV.
777, 785 (2000); Vandello et al., supra note 70, at 1327; see Jennifer K. Bosson & Joseph A.
Vandello, Precarious Manhood and Its Links to Action and Aggression, 20 CURRENT
DIRECTIONS IN PSYCHOL. SCI. 82, 83 (2011).
72. See generally SAN JOSE REPORT, supra note 49.
73. Id. at 11; see also Phillip Atiba Goff et al., Voices of Dominance (unpublished
manuscript) (on file with author).
74. SAN JOSE REPORT, supra note 49, at 11; Goff et al., supra note 73.

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What might explain these results? First, despite the fact that police
departments have become more gender diverse since the 1950s,75
hypermasculinity amongst the rank and file is still the norm.76 This
orientation persists because departments remain male-dominated and
continue to highlight the importance of physical strength in recruitment
materials, reinforce the hypermasculine ideal during academy training, and
police it through the harassment of women and gay men.77 The
militarization of the police also strengthens the association between
policing and violent masculinity.78 In hypermasculine environments, it is
foreseeable that officers would respond to masculinity threats with
aggression and even violence in order to prove their masculine identity.
Second, black men likely pose the greatest threat to an officer’s
masculinity, especially if they are disrespectful or noncompliant, because
they are stereotyped, both consciously and unconsciously, as more
masculine than other men.79 Thus, both race and masculinity intersect to
facilitate racial violence.
Consider the grand jury testimony of Officer Wilson alleging that
Michael Brown called him “too much of . . . a pussy to shoot.”80 No doubt
this statement, coupled with Michael Brown’s race and physical size,
challenged Wilson’s masculinity and might explain why the confrontation
between Brown and Wilson ended in violence. Even if Officer Wilson is
not consciously racist, unconscious biases may have influenced his
perceptions of the threat posed by Brown. In fact, his grand jury testimony
referring to Brown as “super human” and “a demon” suggests the officer
also dehumanized him.81 Additionally, masculinity threat can explain why
Officer Wilson confronted Brown in the first place instead of calling for
75. David Alan Sklansky, Not Your Father’s Police Department: Making Sense of the
New Demographics of Law Enforcement, 96 J. CRIM. L. & CRIMINOLOGY 1209, 1210 (2006).
CRITIQUE AND
76. JAMES W. MESSERSCHMIDT, MASCULINITIES AND CRIME:
RECONCEPTUALIZATION OF THEORY 178 (1993) (citing Jennifer Hunt, The Development of
Rapport Through the Negotiation of Gender in Field Work Among Police, 43 HUM. ORG.
283 (1984)); Susan Ehrlich Martin & Nancy C. Jurik, DOING JUSTICE, DOING GENDER:
WOMEN IN LAW AND CRIMINAL JUSTICE OCCUPATIONS 43 (2d ed. 2006).
77. Richardson & Goff, supra note 23, at 131–32.
78. See Peter B. Kraska & Victor E. Kappeler, Militarizing American Police: The Rise
and Normalization of Paramilitary Units, 44 SOC. PROBS. 1, 2–3 (1997); U.S. Dep’t of
Justice, Technology Transfer from Defense: Concealed Weapon Detection, 229 NAT’L INST.
OF JUST. J. 1, 35 (1995) (the 1981 Military Cooperation with Law Enforcement Act and the
1984 National Defense Authorization Act gave military weapons and technology to
departments to aid in the drug war); see also National Defense Authorization Act for Fiscal
Year 1997, Pub. L. No. 104-201, 110 Stat. 2422, 2639 (1996), available at
www.nps.gov/legal/laws/104th/104-201.pdf; RADLEY BALKO, OVERKILL: THE RISE OF
PARAMILITARY POLICE RAIDS IN AMERICA 27 (2006).
79. For an in-depth discussion, see Richardson & Goff, supra note 23, at 120–28.
80. Conor Friedersdorf, Witnesses Saw Michael Brown Attacking—and Others Saw Him
Giving Up, ATLANTIC (Nov. 25, 2014), http://www.theatlantic.com/national/
archive/2014/11/major-contradictions-in-eyewitness-accounts-of-michael-brownsdeath/383157/.
81. Frederica Boswell, In Darren Wilson’s Testimony, Familiar Themes About Black
Men, NPR (Nov. 26, 2014), http://www.npr.org/blogs/codeswitch/2014/11/26/366788918/indarren-wilsons-testimony-familiar-themes-about-black-men.

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backup before engaging with him. As one police veteran relates,
“[O]fficers who ‘call for help’ are seen as weak, as vulnerable, and as
feminine . . . . The subculture dictates that ‘real men’ will never need to
call for help; those who do are often subjected to ridicule and scorn after
having done so.”82
III. IMPLICATIONS
The influence of implicit racial biases, stereotype threat, and masculinity
threat on police behavior explains why racial violence is inevitable and
overdetermined even in the absence of conscious racial animus. Thus,
while punishing bad racial actors is important,83 racial violence will
continue unabated even if we could discover and remove all consciously
racist officers from the department. That is because the major problem is
not dispositional, but rather, situational.
The key to reducing racial violence is to transform current policing
strategies and cultures that create an “us-versus-them” mentality between
officers and the non-white communities they police. This is because
positive intergroup contact is a proven method for reducing the influence of
implicit racial biases84 and getting to know people makes it more difficult
to dehumanize them.85 Furthermore, when officers are able to build
relationships with non-white citizens, they are less likely to worry about
being stereotyped as racist.
However, officers are rarely in situations where they interact in positive
ways with non-white citizens. Rather than creating incentives for officers
to work together with the community to identify and address the underlying
causes of disorder, current policing practices discourage the social work
aspects of policing in favor of proactive, aggressive policing strategies that
prize arrests over problem-solving. Such practices make it difficult for
officers and community members to have positive contacts and to build
relationships that are not defined by distrust and suspicion. As a result,
officers experience stereotype threat because they know the community
believes they are racist. Furthermore, because of their awareness that

82. Thomas Nolan, Behind the Blue Wall of Silence, 12 MEN & MASCULINITIES 250, 255
(2009).
83. Strategies for holding officers liable for their misconduct is woefully inadequate. See
Erwin Chemerinsky, Op-Ed., How the Supreme Court Protects Bad Cops, N.Y. TIMES, Aug.
27, 2014, at A23 (discussing how U.S. Supreme Court decisions protect officers from
liability); see also Kevin M. Keenan & Samuel Walker, An Impediment to Police
Accountability? An Analysis of Statutory Law Enforcement Officers’ Bills of Rights, 14 B.U.
PUB. INT. L.J. 185 (2005) (discussing the impact of police officer bill of rights on police
accountability); Barbara E. Armacost, Organizational Culture and Police Misconduct, 72
GEO. WASH. L. REV. 453, 463 (2004); Rachel A. Harmon, The Problem of Policing, 110
MICH. L. REV. 761 (2012).
84. Calvin K. Lai et al., Reducing Implicit Racial Preferences: A Comparative
Investigation of 17 Interventions, 143 J. EXPERIMENTAL PSYCHOL. 1765, 1772 (2014); Calvin
K. Lai et al., Reducing Implicit Prejudice, 7 SOC. & PERSONALITY PSYCHOL. COMPASS 315,
317 (2013).
85. Richardson & Goff, supra note 23, at 123.

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members of the community view them as illegitimate, they enact command
presence, which escalates rather than defuses already tense situations.
Thus, building relationships between officers and the community can
reduce racial violence. Of course, doing this is easier said than done.
Although community policing is a popular philosophy, most officers remain
disengaged from the communities they police and continue to denigrate
aspects of the job they associate with “social work.”86 These attitudes are
understandable since success continues to be measured largely by the
number of arrests made and how quickly officers respond to calls for
service.87 Why would an officer expend energy on more time-consuming
problem-solving activities when these are unlikely to be rewarded?
Police departments are not solely to blame for this reward structure.
Some federal grants create incentives for departments to engage in
aggressive, proactive policing by tying funds to the number of arrests
made.88 It is no surprise, then, that departments encourage their officers to
engage in policing practices such as stops and frisks that result in arrests but
which end up alienating communities. Thus, creating incentives for officers
to focus more on relationship building and problem-solving rather than on
arrests will require interventions at both the institutional and national level.
Rewarding the problem-solving and social work aspects of policing will
naturally lead to changes in the hypermasculine police culture because those
individuals not interested in engaging in this type of policing will no longer
be attracted to the field. Furthermore, as these problem-solving and
relational skills become more important, departments will have to begin
recruiting individuals who excel in these areas, again helping to slowly
change the culture.
While this intervention is large-scale and long-term, a more concrete
intervention is for departments to begin collecting data to determine
whether any of their practices result in racially disparate impacts. Some
departments are already doing this. For instance, in 2008, the police chief
in Kalamazoo, Michigan, did just that. Responding to community concerns
over racial profiling, he put systems in place to gather data and hired a
consulting group to conduct a study within his department.89 When the
study revealed racial disparities in the policing of black citizens, he shared
the report with the community and implemented changes in policy that
required officers to have reasonable suspicion before asking for consent to
search.90

86. For an in-depth discussion, see id. at 143–47.
87. George L. Kelling & Mark H. Moore, The Evolving Strategy of Policing, in
COMMUNITY POLICING: CLASSICAL READINGS 105–06 (Willard M. Oliver ed., 2000); George
L. Kelling & William J. Bratton, Implementing Community Policing: The Administrative
Problem, in COMMUNITY POLICING, supra, at 261.
88. MICHELLE ALEXANDER, THE NEW JIM CROW: MASS INCARCERATION IN THE AGE OF
COLORBLINDNESS 75–82 (2010).
89. See Lorie Fridell, Psychological Research Has Changed How We Approach the
Issue of Biased Policing, SUBJECT TO DEBATE, May–June 2014.
90. Id.

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Another fruitful example is exemplified by the work of the Center for
Policing Equity (CPE) based at UCLA.91 CPE has been successful in
working closely with police departments to identify some of the causes of
racially biased policing and to implement solutions.92 For instance, when
working with the Las Vegas Police Department, the group found that many
uses of force by police officers against racial minorities occurred after foot
chases in non-white neighborhoods. Acknowledging that it would be
difficult for officers engaged in a foot chase to stop and think about whether
implicit racial biases were influencing their behaviors, CPE instead helped
the department develop new rules to address the problem. Under the new
policy, the officer engaged in a pursuit would no longer be allowed to lay
hands on the suspect. Rather, another officer would be required to step in if
force was necessary. This change resulted in a significant decline in the use
of force against people of color.93
One challenge is that departments may be reluctant to gather racial data
because of concerns that exposing their practices to outside review will
subject them to liability. CPE has developed a way to overcome liability
concerns. CPE researchers and departments sign a memorandum of
understanding that provides legal protection against disclosure of
confidential data, guarantees departments that they will be the first to learn
of the results, allows departments to elect to remain anonymous when the
results are published, and gives them a reasonable time to implement
solutions, inform the press, or do nothing.94
Admittedly, it can be difficult to speak to police departments about
gathering racial data because of the inevitable defensiveness that often
accompanies discussions of race. This problem is exacerbated by the fact
that many people employ colorblindness as a strategy to reduce racial
anxiety.95 CPE has been successful in overcoming this defensiveness and
developing close, working relationships with numerous police departments.
Goff relates he has achieved this in part by approaching departments guided
by two assumptions. The first is “that everyone involved wants to do the
right thing—that is, that the research partners are not bigots.”96 The second
is that “ridding a department of racism is both a worthy goal and a difficult
one.”97 These assumptions help overcome understandable defensiveness

91. CPE is “a research and action think tank that works with police departments to
conduct original research in the interest of improving equity in police organizations and the
delivery of police services.” Phillip Atiba Goff et al., (The Need for) A Model of
Translational Mind Science Justice Research, 1 J. SOC. & POL. PSYCHOL. 385, 391 (2013).
Goff is CPE’s cofounder and president.
92. Id. at 394.
93. Mooney, supra note 22.
94. Goff et al., supra note 91, at 392.
95. Evan P. Apfelbaum et al., Seeing Race and Seeming Racist? Evaluating Strategic
Colorblindness in Social Interaction, 95 J. PERSONALITY & SOC. PSYCHOL. 918, 919 (2008);
Phillip Atiba Goff et al., Anything but Race: Avoiding Racial Discourse to Avoid Hurting
You or Me, 4 PSYCHOL. 335 (2013).
96. Goff et al., supra note 91, at 393.
97. Id.

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that arises when issues of race are discussed as well as when racial
disparities, sometimes stark, are discovered.98
Moving beyond a focus on conscious racial bias is another way to
overcome defensiveness. The Fair and Impartial Policing (FIP) program
has been successful in educating departments about the influence of implicit
biases. FIP is a comprehensive program that relies on the science of
implicit racial bias to help departments move toward unbiased policing
practices.99 It “addresses the ill-intentioned police who produce biased
policing and the overwhelming number of well-intentioned police in this
country who aspire to fair and impartial policing, but who are human like
the rest of us.”100 The program involves trainings as well as issues related
to recruitment and hiring, internal policies and procedures, outreach to the
community, and creating accountability mechanisms and measurement
tools to track data.101 This program has been adopted by a number of
police departments102 and several states are considering statewide adoption
of the program.103 The program is being taken seriously by police
leadership104 and is gaining traction.105 Many officers who have taken part
in the program have praised it, making comments like: “It changed my
perception,”106 “I will better recognize bias and be able to address it with
officers,”107 and “could see doing this training in my retirement, would feel
proud and honored to be involved in a program like this.”108
Not only can this program help departments understand the importance
of being race conscious when it comes to policing, but also, if departments
begin to implement trainings such as those provided by the FIP program,
they also can begin to tie promotions and other job perks to demonstrable
98. Id.
99. For information on this program, see Lorie Fridell, FIP Client, FAIR & IMPARTIAL
POLICING, http://www.fairimpartialpolicing.com (last visited Apr. 23, 2015).
100. Id.
101. Id.
102. Lorie
Fridell,
Press,
FAIR
&
IMPARTIAL
POLICING,
http://www.fairimpartialpolicing.com/press/ (last visited Apr. 23, 2015).
103. See Fridell, supra note 99.
104. See, e.g., Tracey G. Cove, Implicit Bias and Law Enforcement, POLICE CHIEF, Oct.
2011, at 44, available at http://static.squarespace.com/static/54722818e4b0b3ef26cdc085/
t/54790aece4b03c29747eb163/1417218796679/press-thepolicechief.pdf.
105. See Fridell, supra note 99.
106. UNIV. OF CAL. BERKELEY POLICE DEP’T, OFFICERS: RACIAL PROFILING, FAIR AND
IMPARTIAL
POLICING
B,
available
at
http://static.squarespace.com/static/
54722818e4b0b3ef26cdc085/t/5472b283e4b0367870bd3335/1416802947888/rberkb.pdf
(compiling course evaluations).
107. LORIE A. FRIDELL, FAIR AND IMPARTIAL POLICING 5, available at
http://static.squarespace.com/static/54722818e4b0b3ef26cdc085/t/5478bbd4e4b045935f33df
73/1417198548003/overview-program.pdf.
108. UNIV. OF CAL. BERKELEY POLICE DEP’T, OFFICERS: RACIAL PROFILING, FAIR AND
IMPARTIAL
POLICING
A,
available
at
http://static1.squarespace.com/static/
54722818e4b0b3ef26cdc085/t/5472b245e4b081a2addcb9a9/1416802885101/rberka.pdf
(compiling course evaluations); see also Lorie A. Fridell, Racially Biased Policing: The
Law Enforcement Response to the Implicit Black-Crime Association, in RACIAL DIVIDE:
RACIAL AND ETHNIC BIAS IN THE CRIMINAL JUSTICE SYSTEM (Michael J. Lynch, E. Britt
Patterson & Kristina K. Childs eds., 2008).

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changes in an officer’s behaviors in response to what he or she learned.
This is not only a way of changing incentives, but it also will help to change
department culture as officers who are not motivated and committed to
making the necessary adjustments will slowly be weeded out of the
department.
CONCLUSION
It will not be easy to transform current policing practices and culture in
order to address racial violence. Doing so will not only require changes
within police departments but also in legal doctrine and legislation. This is
a tall order given that the problem of policing and race is a perennial one.
However, now is a particularly auspicious time to push for meaningful,
groundbreaking changes to police practices and culture. The high-profile
cases of police violence, intransigence, and arrogance,109 coupled with
signs of optimism110 have brought issues of policing to the public
consciousness in ways not seen in recent history. Furthermore, the public
protests that have sprung up across the country in response to the failure to
indict police officers for killing unarmed black men have and will continue
to play a critical role in facilitating the debate over the meaning of policing
and how it should be reformed. As Professors Lani Guinier and Gerald
Torres explained in a recent article, social movements can play a role in
facilitating “the cultural shifts that make durable legal change possible.”111
Perhaps through their activism bringing attention to and contesting current
policing practices, these movements can spark changes in how our society
views the police in ways that will make changes to policing seem inevitable
and appropriate. Until this occurs, we can expect that racial violence
against unarmed black men will continue unabated.

109. Matt Taibbi, The NYPD’s “Work Stoppage” Is Surreal, ROLLING STONE (Dec. 31,
2014),
http://www.rollingstone.com/politics/news/the-nypds-work-stoppage-is-surreal20141231.
110. For instance, the police chief of Richmond, California, recently took part in a protest
against police brutality, holding a sign that read “Black Lives Matter.” Robert Rogers,
Richmond Police Chief a Prominent Participant in Protest Against Police Violence, CONTRA
COSTA TIMES
(Dec.
9,
2014),
http://www.contracostatimes.com/west-countytimes/ci_27102218/richmond-police-chief-prominent-participant-local-protest-against.
Additionally, in December 2014, the Obama Administration created the Task Force on 21st
Century Policing. See David Hudson, President Obama Creates the Task Force on 21st
Century
Policing,
WHITE
HOUSE
BLOG
(Dec.
18,
2014),
http://www.whitehouse.gov/blog/2014/12/18/president-creates-task-force-21st-centurypolicing. The task force “will examine, among other issues, how to strengthen public trust
and foster strong relationships between local law enforcement and the communities that they
protect, while also promoting effective crime reduction.” Press Release, Office of the Press
Sec’y, White House, Fact Sheet: Task Force on 21st Century Policing (Dec. 18, 2014),
http://www.whitehouse.gov/the-press-office/2014/12/18/fact-sheet-task-force-21st-centurypolicing.
111. Lani Guinier & Gerald Torres, Changing the Wind:
Notes Toward a
Demosprudence of Law and Social Movements, 123 YALE L.J. 2740, 2743 (2014).

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APPENDIX G‒CENTER FOR MINDFULNESS IN CORRECTIONS

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APPENDIX H‒ AVERAGE NUMBER
INMATES , JUNE 2014- JUNE 2015.
Average #
Incidents
per 100
Inmates

June
2015
Inmate
Count

June
2015
SNY
Pop

SAC
LAC
SVSP
CMF

5.13
1.96
1.95
1.69

2319
3494
3678
2269

N/A
896
1468
N/A

COR
KVSP
CAL
MCSP
RJD
HDSP

1.50
1.30
1.30
1.18
1.10
1.07

4405
3638
3774
2941
3148
3300

1850
1578
922
2778
2118
1009

PBSP
NKSP
WSP
DVI
CRC
SATF
CMC
CCC
CEN
SQ
CIM
SOL
PVSP
FSP
ISP

0.97
0.89
0.85
0.81
0.77
0.75
0.72
0.71
0.67
0.65
0.62
0.59
0.55
0.53
0.50

2742
4365
4881
2117
2434
5581
3809
4089
3489
3687
3802
3866
2271
2876
3401

N/A
N/A
N/A
N/A
784
3156
N/A
N/A
871
N/A
1810
N/A
1274
N/A
1561

CCI
SCC
VSP
ASP
CVSP
CTF

0.50
0.44
0.35
0.35
0.25
0.21

3931
4345
3379
2766
2264
5167

3186
788
3326
2324
1178
2668

Prison

100

OF INCIDENTS PER

All Levels
I, IV, PSU,
SHU
I, III, IV
I, III, IV
I, II, III
I, III, IV, SHU,
PHU
I, IV, THU
I, IV
I, III, IV
I, III, IV
I, III, IV
I, IV, PSU,
SHU
I, III, RC
I, III, RC
I, II, RC
II
II, III, IV
I, II, III
I, II, III
I, III, IV
II, RC
I, II, RC
II, III
I, III
I, II, FWF
I, III
I, II, III, IV,
SHU
I, II, III
II
II
I, II
I, II

SNY
Levels

Mission

N/A
IV
III, IV
N/A

HS
HS
HS
FOPS

III, IV
IV
IV
I, III, IV
III, IV
III, IV

HS
HS
GP
GP
RC
HS

N/A
N/A
N/A
N/A
II
II, III, IV
N/A
N/A
III
N/A
II
N/A
III
N/A
I, III
I, II, III,
IV
III
II
II
I, II
II

HS
RC
RC
RC
RC
HS
RC
RC
GP
RC
RC
GP
GP
FOPS
GP
HS
RC
GP
GP
GP
GP

The institutions highlighted in green house the SNY inmates described in the columns.
2015 Special Review: High Desert State Prison
Office of the Inspector General

Page 107
State of California

APPENDIX I‒ AVERAGE NUMBER OF INMATE DISCIPLINARY
ACTIONS PER 100 INMATES JUNE 2014- JUNE 2105.

Prison
LAC

Average #
Inmate
Disciplinary
Actions, per
100 Inmates
16.03

June
2015
Inmate
Count

June
2015
SNY
Pop

3494

896

SAC
CCC
MCSP
SCC
CAL
CEN
CRC
KVSP
SVSP
SATF
RJD
SOL
WSP

15.05
10.82
9.89
9.75
8.82
8.22
7.77
7.75
7.64
7.09
7.00
6.58
6.41

2319
4089
2941
4345
3774
3489
2434
3638
3678
5581
3148
3866
4881

N/A
N/A
2778
788
922
871
784
1578
1468
3156
2118
N/A
N/A

COR
PVSP
CMF
ISP
DVI
CIM
CMC
NKSP
ASP

6.28
6.20
5.65
5.60
5.29
5.22
5.00
4.73
4.02

4405
2271
2269
3401
2117
3802
3809
4365
2766

1850
1274
N/A
1561
N/A
1810
N/A
N/A
2324

PBSP
HDSP
VSP
FSP

4.01
3.97
3.56
3.12

2742
3300
3379
2876

N/A
1009
3326
N/A

CCI
CVSP
SQ
CTF

2.97
2.96
2.86
2.34

3931
2264
3687
5167

3186
1178
N/A
2668

All Levels at
this Prison
I, III, IV
I, IV, PSU,
SHU
I, II, III
I, III, IV
I, II, III
I, IV
I, III, IV
II
I, IV, THU
I, III, IV
II, III, IV
I, III, IV
II, III
I, III, RC
I, III, IV, SHU,
PHU
I, III
I, II, III
I, III
I, II, RC
I, II, RC
I, II, III
I, III, RC
II
I, IV, PSU,
SHU
I, III, IV
II
I, II, FWF
I, II, III, IV,
SHU
I, II
II, RC
I, II

SNY
Levels
at this
Prison

Mission

IV

HS

N/A
N/A
I, III, IV
III
IV
III
II
IV
III, IV
II, III, IV
III, IV
N/A
N/A

HS
RC
GP
RC
GP
GP
RC
HS
HS
HS
RC
GP
RC

III, IV
III
N/A
I, III
N/A
II
N/A
N/A
II

HS
GP
FOPS
GP
RC
RC
RC
RC
GP

N/A
III, IV
II
N/A
I, II, III,
IV
I, II
N/A
II

HS
HS
GP
FOPS
HS
GP
RC
GP

The institutions highlighted in green house the SNY inmates described in the columns.

2015 Special Review: High Desert State Prison
Office of the Inspector General

Page 108
State of California

APPENDIX J‒ WCI

TASER BODY CAMERA PILOT

TASER BODY CAMERA PILOT
WCI began a pilot in conjunction with TASER International with the Institution receiving 10 units
(6 AXON Flex and 4 AXON Body) the pilot also included a docking station as well as 40 staff
members with accounts to Evidence.com for video review, archiving and storage purposes.
During the 6 month pilot WCI staff created over 15,000 video downloads ranging from a couple
of minutes to 45 minutes in duration. During this time the following areas were compared PREA
allegations against staff in Segregation, Reactive use of force incidents and inmate complaints.
PREA Complaints Segregation by Month
July 2013 – 2

July 2014 – 2

August 2013 – 3

August 2014 – 1

September 2013 – 4

September 2014 – 6

October 2013 – 1

October 2014 – 2

November 2013 – 4

November 2014 – 1

December 2013 – 2

December 2014 – 9

Total – 16

Total – 21

Between January 2014 and June 2014 – 18
NCH Program PREA investigations initiated between July 2013 – July 2014 – 0 Total
NCH Program PREA investigations initiated since July 2014 – 4 Total
Staff Assaults Segregation by Month
July 2013 – 1

July 2014 – 1

August 2013 – 3

August 2014 – 3

September 2013 – 4

September 2014 – 1

October 2013 – 3

October 2014 – 1

November 2013 – 1

November 2014 – 2

December 2013 – 7

December 2014 – 1

Total – 19

Total – 9

*Between January and June 2014 – 12
2015 Special Review: High Desert State Prison
Office of the Inspector General

Page 109
State of California

APPENDIX J‒ WCI

TASER BODY CAMERA PILOT

Staff Assaults Segregation
Between July and December 2013 – WCI had 19 staff assaults in Segregation
Between July and December 2014 – WCI had 9 staff assaults in Segregation
Inmate Complaints Segregation
From January 1, 2014 – June 30, 2014 – 549 total inmate complaints approximately 91 per
month
From July 1, 2014 – October 9, 2014 – 307 total inmate complaints approximately 100 per
month
From January 1, 2014 – June 30, 2014 – 57 inmate complaints regarding staff issues
From July 1, 2014 – October 9, 2014 – 34 inmate complaints regarding staff issues
From January 1, 2014 to June 30, 2014 there were 2 staff misconduct complaints from SEG
From July 1, 2014 to Present there were 4 staff misconduct complaints from SEG
From January 1, 2014 to June 30, 2014 there were 7 staff sexual misconduct complaints from
SEG
From July 1 to Present, there were also 7 such complaints from SEG
At the conclusion of the pilot program WCI found that there was a difference in the amount of
reactive use of force incidents however PREA allegation and inmate complaints remained
consistent. WCI anticipated that the number of allegations would not change dramatically.
Unlike Law Enforcement who utilize Body Cameras the pilot program was conducted strictly in a
Maximum Security Segregation Building which contained approximately 180 inmates with
lengthy history of assaultive and self-harm behaviors.
WCI did find the body cameras to be very effective. The AXON flex camera is the more
expensive model available and can be mounted in a variety of different ways however we found
that the small cord connecting the camera to the controller could be damaged/broken pretty
easily. The AXON body camera is cheaper and more durable. Both cameras provided roughly
the same view of an incident. They were both excellent for interactions at the cell door/trap
and when speaking to inmates. They were not very effective while escorting inmates however
the audio did give a perspective of what was taking place.

2015 Special Review: High Desert State Prison
Office of the Inspector General

Page 110
State of California

APPENDIX J‒ WCI

TASER BODY CAMERA PILOT

In the beginning of the pilot staff were very apprehensive about wearing the camera while the
inmate population appeared to be “playing” to the camera attempting to provoke an
unprofessional response from staff. Training regarding Professional Communication Skills was
conducted with all staff involved in the pilot and after a couple of weeks staff were comfortable
wearing the cameras and the inmates had adjusted as well. I believe the cameras definitely
enhanced the professionalism of staff and how they communicated with inmates. I could see a
pretty dramatic change in the communication level of staff throughout the pilot and I was able
to see which staff communicated well with inmates.
Although the amount of complaints or PREA allegations did not change it was much easier to
review the allegations and determine if an incident occurred.
I believe the AXON body camera would be beneficial to a Security staff member however the
degree they could be utilized would be determined by cost. The camera is very inexpensive the
cost will be incurred with licensing for Evidence.com and storing data in the accounts as well as
Evidence.com cold storage for long term archiving of videos.
The following is the draft policy utilized by WCI staff involved in the Taser Body Camera Pilot
PURPOSE: To insure that unexpected use of force, staff assisted strip searches and medical
emergencies can be recorded and preserved in a Segregation setting.
POLICY: An inmate may be recorded by a body camera worn by Segregation staff while in
Segregation. This may occur both during planned and reactive use of force incidents and will
include any staff assisted strip searches as well as incident that occur at the cell door trap. The
Waupun Correctional Institution requires that whenever the body camera is utilized, the
subsequent outlined procedures will be adhered to.
GENERAL: Designated Segregation staff will be provided with either an Axon Flex body camera
(worn either on the staff member’s eyewear, hat, collar or epaulette). Or the Axon body camera
(worn on the uniform shirt or jacket). Staff will utilize the body camera assigned to them and
will be registered camera users with evidence.com for data collection and storage.
PROCEDURE:
Designated staff will be assigned a body camera and be entered into evidence.com for data
tracking and evidence preservation purposes. The following are instances when staff will
activate their body camera.
1.

When responding to any type of Institution emergency.

2.

Whenever interacting with a Segregation inmate at the cell door trap.

3.

During any staff assisted strip search. During this type of search the staff member wearing
the camera will conduct the search.

2015 Special Review: High Desert State Prison
Office of the Inspector General

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State of California

APPENDIX J‒ WCI

TASER BODY CAMERA PILOT

4.

Anytime a staff member has physical contact with the inmate (escorting, responding to
medical emergencies, restraining a disruptive inmate and dealing with a verbally disruptive
inmate, etc.)

5.

Staff will activate the camera by pressing the button to activate the camera as they respond
to an emergency, when going onto a Segregation range where they anticipate having trap
side contact or encounter a disruptive inmate.

6.

Only at the completion of the incident or scene will the staff member shut off the body
camera. Once a video camera has arrived on scene the body camera will continue to collect
data and will not be turned off until the scene is cleared by the Shift Supervisor.

7.

Staff responsible for utilizing a body camera will register with evidence.com and they will
ensure they are logged into a camera at the beginning of their shift. This will occur at the
start of each day. They will ensure the camera they utilize is placed in the appropriate
docking station at the end of their shift.
MONITORING
1.

The staff member will be responsible for monitoring their own recorded video
footage/evidence. They will not be permitted access to other staff members
downloads. Staff can only access or review their downloaded footage while in pay
status while at the WCI.

2.

Audio and video footage may be reviewed by the staff member assigned to the camera
however only a system administrator will have access to delete any footage.

3.

Whenever possible staff will ensure that the inmate is aware that their actions are being
recorded with both audio and video footage, however there is no requirement to inform
the inmate they are being monitored or recorded.

4.

The body camera will be utilized for monitoring or recording inmates and their actions it
is not intended to be used to record staff for disciplinary actions.

5.

The Warden will determine which staff will have access to review multiple camera users.

RECORDKEEPING
1.

Whenever a staff member is involved in an incident they will be required to complete all
necessary documentation to include any incident reports (DOC-2466), Adult Conduct
Reports (DOC-9 & 9A), Observation of Offender (DOC-112), Review of Placement of
Offender in Restraints (DOC-111).

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Office of the Inspector General

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State of California

APPENDIX J‒ WCI

TASER BODY CAMERA PILOT

2.

An electronic record will be kept within evidence.com of anytime a video account is
accessed and will include the date, time and who accessed the video account. Only the

3.

System Administrator will have the ability to delete a video and that will be included on
the evidence.com electronic record.

4.

The Security Director will assign a staff member to transpose or capture date on a
recordable disk for possible disciplinary action or from Law Enforcement.

2015 Special Review: High Desert State Prison
Office of the Inspector General

Page 113
State of California

2015 Special Review:
High Desert State Prison
Susanville, CA
OFFICE OF THE INSPECTOR GENERAL
Robert A. Barton
INSPECTOR GENERAL

Roy W. Wesley
CHIEF DEPUTY INSPECTOR GENERAL

STATE OF CALIFORNIA
December 2015