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File: JUNE NOTE: While Colorado school districts are not required by law to adopt an exhibit on this subject, this sample reflects documentation and notification requirements school districts must

How to fill out student restraint incident report

How to fill out a student restraint incident report:

1. Gather all necessary information: Before filling out the report, make sure you have collected all relevant details about the incident. This may include the date, time, location, and individuals involved.
2. Clearly describe the incident: Begin the report by providing a comprehensive and accurate description of what transpired during the student restraint. Include specific actions taken, behaviors exhibited, and any injuries sustained.
3. Identify witnesses: If there were any witnesses present during the incident, it is crucial to document their names and contact information. Their statements may serve as supporting evidence or provide additional perspectives.
4. Document student's information: Provide the student's full name, age, grade level, and any other pertinent details. It is also essential to include the student's individual education plan (IEP) or behavior intervention plan (BIP) if applicable.
5. Note staff involved: List the names and positions of all staff members who were involved in the incident. This includes any individuals who directly restrained the student or provided support during the situation.
6. Describe de-escalation attempts: If there were any attempts made to de-escalate the situation before resorting to restraint, clearly outline those efforts. This could involve explaining strategies, interventions, or techniques utilized to manage the student's behavior.
7. Document restraint techniques used: Provide a detailed account of the specific types of restraints used, such as physical holding, mechanical restraints, or seclusion. Include the duration of the restraint and any observations made during that time.
8. Describe the student's response: Record the student's reactions and behavior during and after the restraint. Note any changes in their emotional state, injuries sustained, or any other significant observations.

Who needs a student restraint incident report:

1. School administrators: Principals, assistant principals, and other administration staff may require this report to evaluate the situation and assess any necessary actions or interventions.
2. Teachers and support staff: The individuals involved in the restraint may need to provide accurate and detailed documentation to ensure a comprehensive understanding of the incident and support the student in the future.
3. Parents or guardians: It is essential to communicate the incident promptly and accurately with the student's parents or guardians. The report can serve as a reliable source of information for them, fostering transparency and collaboration.
4. School district officials: District-level personnel responsible for overseeing student safety and compliance may request these reports for data analysis, policy improvement, or legal purposes.
5. Legal authorities: In some cases, law enforcement or legal professionals may require student restraint incident reports for investigations or legal proceedings.

Remember, each educational institution may have specific guidelines and requirements for completing a student restraint incident report. It is crucial to follow your school's policies and procedures to ensure accuracy and compliance.

For pdfFiller’s FAQs

What is student restraint incident report?

Student restraint incident report is a document that details any instance where physical force or mechanical restraints are used on a student in a school setting.

Who is required to file student restraint incident report?

School staff members who are involved in the incident are required to file the student restraint incident report.

How to fill out student restraint incident report?

To fill out the student restraint incident report, school staff must provide details on the date, time, location, individuals involved, reason for restraint, type of restraint used, and any injuries sustained.

What is the purpose of student restraint incident report?

The purpose of the student restraint incident report is to document and track instances of student restraint to ensure proper procedures are followed and to monitor trends.

What information must be reported on student restraint incident report?

The student restraint incident report must include details on the date, time, location, individuals involved, reason for restraint, type of restraint used, any injuries sustained, and any follow-up actions taken.

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