The infernal conditions are described in a report issued Tuesday by the Department of Homeland Security’s office of inspector general, which audited the facility, overseen by Immigration and Customs Enforcement (ICE), in Adelanto, Calif. It has a capacity of 1,940 detainees and is run by GEO Group, which owns and operates 71 federal prisons and detention centers with a combined total of 75,500 beds, according to its website.

GEO declined to comment and referred inquiries to ICE.

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ICE officials said they have ordered a full inspection and review of the Adelanto facility that will begin this month. ICE said it would also seek input and assistance from its health teams, though officials challenged findings in the report related to the placement of detainees in segregation cells and a lack of language interpreters.

“The safety, rights and health of detainees in ICE’s care are of paramount concern and Adelanto, like all ICE detention facilities, is subject to stringent, regular inspections,” ICE spokeswoman Lori Haley said in a statement. “ICE takes seriously the [Inspector General’s] findings, and has agreed to conduct a full and immediate review of the center to ensure compliance with detention standards and expedite necessary corrective actions.”

The report details numerous alleged instances of substandard care and neglect by jailers who “prematurely and inappropriately” locked detainees in segregation cells without proper review, the report found, actions that posed “a significant threat” to detainees’ rights and their mental and physical health.

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The auditors found gross violations of health and safety standards, including detainees forced to wait weeks or months to see a doctor, the report says. Basic dental care was nonexistent, it notes. With only two dentists on staff, services at the facility were so poor that inspectors could not find records of detainees receiving cleanings or fillings in the past four years.

One dentist told inspectors that there was no time for cleanings or fillings, and that it was up to inmates to take care of their own oral hygiene despite a lack of supplies. “The dentist dismissed the necessity of fillings if patients commit to brushing and flossing,” the report said. “Floss is only available through detainee commissary accounts, but the dentist suggested detainees could use string from their socks to floss if they were dedicated to dental hygiene.”

DHS inspectors reviewed all requests for dental fillings since 2014 and found that although the jail’s two dentists identified cavities and placed detainees on a waiting list for fillings, no detainees received them. “One detainee we interviewed reported having multiple teeth fall out while waiting more than 2 years for cavities to be filled,” the report said.

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Under President Trump, tougher immigration enforcement and an increase in ICE arrests have pushed the detainee population to its highest level in years, with an average of 42,105 inmates in custody per day during the government’s current fiscal year, up from 38,106 last year, according to the latest government figures.

On Monday, The Washington Post reported on critical findings in a separate DHS inspector general report that enumerated mistakes in the Trump administration’s “zero tolerance” policy separating migrant children from their parents at the border. At least two other internal reports are expected to be released in the coming weeks that will look at that policy’s failures, according to administration officials with knowledge of the reports.

Trump’s crackdown has strained detention facilities and put renewed attention on substandard conditions at some, including a heightened risk of suicide among inmates held for lengthy periods awaiting court decisions or deportation.

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In March 2017, a 32-year-old detainee at Adelanto died after he hanged himself, and the facility recorded attempts by three other inmates in the months that followed. Between December 2016 and October 2017, inspectors identified at least seven suicide attempts at the jail, located on the outskirts of Victorville, Calif.

Despite this, DHS inspectors arrived in May to find nooses fashioned from twisted bedsheets hanging from air vents in 15 of 20 cells they visited.

“According to the guard escorting us, the nooses are a daily issue and very widespread,” the auditors wrote. “When we asked two contract guards who oversaw the housing units why they did not remove the bed sheets, they echoed it was not a high priority.”

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Detainees told inspectors that inmates were braiding and hanging bedsheets for a variety of reasons, such as creating privacy barriers or makeshift clotheslines within the cells. But one detainee quoted in the report said detainees were trying to hang themselves. “I’ve seen a few attempted suicides using the braided sheets by the vents and then the guards laugh at them and call them ‘suicide failures’ once they are back from medical,” the inmate said.

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One of the worst alleged violations noted by inspectors involved a detainee in a wheelchair who had asked to be placed in a cell by himself but was instead locked in a disciplinary cell for nine days, the report says.