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ACB-R2 Incident
Report Plan And
Response Plan
Violence
and harassment Name of person reporting incident: Date of
Incident: Date
reported: Name of person
incident reported to: Name of person
(s) complaint filed against: Description of
the incident: Result of the
investigation: Response plan: o Team formulates response plan and
communicates plan to both parties Options you
may include, but not limited to: o Educational interventions to increase
sensitivity/respect o Peer mediation o Negotiation o Behavioral contract o Recommendation for disciplinary action o Referral to the Superintendent o Referral to the Discipline Committee o Police Report Name of
Individual Preparing report Submit this
form the Superintendent’s Office within 10 days of the incident. Adoption Date: Reviewed/Approved: |