Writing incident Report Assignment | Online Assignment
8. Graded LP4.2 Skills Check: Writing Incident Reports Hide Folder Information Turnitin® This assignment will be submitted to Turnitin®.Instructions Students will review the movie clips indicated in the “additional assignment instructions” and write an incident report for each one. Use the incident report template found in the Student Resource Folder (LP 4.2 Resource). Copy and paste it into a new Word document for each video. Watch the movie clip, “The Breakfast Club (5/8) Movie CLIP – Andrew and Bender Fight (1985) HD” posted by Movieclips and located at the following link: https://www.youtube.com/watch?v=S5IHNcpa7p0&app=desktop This incident report should be written with a minimum of 250 words. Watch the movie clip, “Ther Perks of Being a Wallflower” (2012) Part 8 of11” posted by MovieClips and located at the following link: https://www.youtube.com/watch?v=Ix8ShPSjmtE until minute 3:10. This incident report should be written with a minimum of 400 words. Submit this assignment in a Word Document to your instructor via the dropbox. This assignment is worth 30 marks. Your work will be evaluated with the corresponding rubric
LP 4.2 Resource: Incident Report Template (2 pages)
CONFIDENTIAL INCIDENT REPORT
| Agency Name: | |||||||||||||
| Location of incident: | |||||||||||||
| Time of incident: | |||||||||||||
| Name(s) of staff involved: | |||||||||||||
| Name(s) of youth involved: | |||||||||||||
| Type of incident:
(mark selection with an X) |
Violence/Physical Assault | Personal Injury | Medical | ||||||||||
| Damage to Property | Theft | Other | |||||||||||
| Drug/Alcohol use | Verbal Assault | ||||||||||||
| For incidents involving assault: | Youth to Youth | Staff to youth | |||||||||||
| Youth to Staff | Staff to staff | Other | |||||||||||
Description of the incident: Answer specifically What happened, Where it happened, When it happened, Who was involved, and How the incident was resolved. Attach another piece of paper if more space is needed.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Parties informed:
- Principal
- Board of Directors
- Parent or legal guardian
- Other agency: _____________________ Worker’s name: _____________________
- Police Badge# ___________ Officer _______________________ Time _______ am / pm
- Ambulance Badge# ___________ Officer _______________________ Time _______ am / pm
- Fire Department Badge# ___________ Officer _______________________ Time _______ am / pm
Describe follow up actions and recommendations:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Staff Name: __________________________ Signature: ____________________________ Date: __________
Staff Name: __________________________ Signature: ____________________________ Date: __________
Staff Name: __________________________ Signature: ____________________________ Date: __________
Supervisor: ___________________________ Signature: ____________________________ Date: __________
CC’d to other agency or program? ___ Yes ___ No
