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Appendix A to <br />PR.515.SCO <br />OCDSB 515-Part I Reporting - School Operations (updated 2019) <br />SAFE SCHOOLS INCIDENT REPORTING FORM – PART I OF II <br />(References: Bill 157, Ministry of Education PPM 144 and 145, and <br />OCDSB Policy P.026.SCO and Procedure PR.515.SCO) <br />Additional documentation / information relating to the incident may be attached to this form if <br />required. <br />Report No: <br />________ <br />CONFIDENTIAL <br />INCIDENT REPORTING FORM – PART I <br />Name of <br />School <br />1. Name of <br />Student(s) <br />Involved (if <br />known) <br />________________________________________ <br />________________________________________ <br />2. Location of <br />Incident <br />(check one) <br />☐ At a location in the school or on school property (please specify) <br />_________________________________________________ <br />☐ At a school-related activity (please specify) <br />________________________________________________________ <br />☐ On a school bus (please specify route number) <br />________________________________________________________ <br />☐ Other (please specify) <br />___________________________________________________ <br />3.Time of <br />Incident Date: __________ Time: __________Location: __________ <br />4. Type of <br />Incident <br />(check all that <br />apply) <br />Activities for which suspension must be considered under section <br />306(1) of the Education Act and Board Procedure PR.515.SCO <br />☐ uttering a threat to inflict serious bodily harm on another person; <br />☐ possessing alcohol, illegal drugs or cannabis; <br />☐ being under the influence of alcohol or cannabis; <br />☐ swearing at a teacher or another person in a position of authority; <br />☐ committing an act of vandalism that causes extensive damage to <br />school property or to property located on the premises of the student’s <br />school; <br />☐ bullying; <br />☐ persistent opposition to authority; <br />☐ habitual neglect of duty as a student as defined by the Education Act, <br />District or school policies;