Public School Incident Report

Public School Incident Report


I. Incident Details

Student Information

Field

Information

Name

Allan Holt

Grade

5th Grade

Age

11

Gender

Male

Student ID

12345

Incident Information

  • Date of Incident: May 1, 2054

  • Time of Incident: 10:30 AM

  • Location: Classroom 203

  • Description of Incident: Allan got into a physical altercation with another student during recess.

II. Witnesses

Witness Name

Role

Contact Information

Mrs. Johnson

Teacher

johnson@email.com

Sarah Thompson

Student

sarah@email.com

Witness Statement

Mrs. Johnson: "I saw Allan and the other student pushing each other and then it escalated into a fight. I intervened immediately."

III. Behavior Details

  • Behavior Description: Physical altercation

  • Target of Behavior: Another student

  • Context of Behavior: During recess

Behavior History

  • Previous Incidents: Allan has had two previous incidents of disruptive behavior in class.

  • Behavioral Patterns: Allan often displays impulsive behavior when provoked.

IV. Actions Taken

  • Immediate Response: Separated the students and calmed them down.

  • Follow-Up Actions: Disciplinary action was taken, and Allan was sent to the principal's office. He was also assigned detention for the rest of the week.

V. Recommendations

  • Preventive Measures: Implementing conflict resolution programs to help students manage conflicts peacefully.

  • Parent/Guardian Notification: A notification was sent to Allan's parents, and a meeting is scheduled for tomorrow.

VI. Additional Information

  • Attachments: None


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