Public School Incident Report

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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	[email protected]
Sarah Thompson	Student	[email protected]

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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