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Approved: 03/13/2012 Code: AEC SECLUSION ARY TIME OUT INCIDENT REPORT File in students Discipline File or enter in Power School Exclusionary time out means removal to a specifically designated area,
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How to fill out seclusionary time out incident

01
Begin by clearly documenting the incident as soon as it occurs.
02
Include the date, time, and location of the incident.
03
Describe the behavior that led to the seclusionary time out, including any triggers or warning signs.
04
Document any staff or witnesses present during the incident.
05
Explain the actions taken to implement the seclusionary time out, such as guiding the individual to the designated space.
06
Describe the duration of the time out and any precautions taken to ensure the safety of the individual.
07
Include any interventions or strategies used to de-escalate the situation.
08
Document any observations made during the time out, including changes in behavior or emotional state.
09
Note any follow-up actions taken after the seclusionary time out, such as debriefing or contacting supervisors.
10
Be thorough and objective in your documentation, providing enough detail to accurately capture the incident and its resolution.

Who needs seclusionary time out incident?

01
Seclusionary time out incidents may be necessary for individuals who exhibit severe disruptive or aggressive behavior that poses a risk to themselves or others.
02
These incidents are typically utilized in specialized settings, such as psychiatric hospitals, residential treatment centers, or special education programs.
03
The decision to use seclusionary time out should be made based on individualized assessments and in accordance with applicable laws and regulations.
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Seclusionary time out incident refers to the practice of isolating a person to manage their behavior or provide them with a break.
School staff, healthcare professionals, or other care providers are required to file seclusionary time out incident reports.
To fill out a seclusionary time out incident report, one must include details such as date, time, location, reason for seclusion, duration, and observations.
The purpose of seclusionary time out incident reports is to document and track instances of seclusion or isolation to ensure they are being used appropriately.
Details such as date, time, location, reason for seclusion, duration, and observations must be reported on a seclusionary time out incident report.
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