Child Behavior Incident Report
I. Introduction
This Child Behavior Incident Report focuses on documenting disruptive classroom behavior exhibited by a student. The purpose of this report is to provide a clear and comprehensive account of the incident, enabling appropriate follow-up actions and interventions.
II. Incident Report Details
1. Incident Information
Date: | 2050-09-15 |
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Time: | 10:30 AM |
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Location: | Classroom 204 |
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2. Student Information
Student Name: | Ken Banks |
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Age: | 10 years |
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Grade Level: | 5th Grade |
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3. Description of the Incident
At approximately 10:30 AM, during a math lesson in Classroom 204, Ken Banks began to disrupt the class by talking loudly and making inappropriate comments. Despite multiple verbal warnings from the teacher, Ken continued to engage in disruptive behavior, including throwing papers across the room and refusing to follow instructions.
4. Individuals Involved
Role | Name |
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Teacher | [YOUR NAME] |
Students Involved/Witnesses | Entire 5th-grade class |
5. Actions Taken
Verbal warnings were given to the student.
The student was asked to move to a different seat to minimize disruption.
The incident was documented for further review.
6. Witnesses
Name | Role |
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Penny Ford | Student (classmate) |
Terry Jenkins | Student (classmate) |
7. Follow-Up Actions
8. Signature
[YOUR NAME]
Teacher
Date: [DATE]
School: [YOUR COMPANY NAME]
Address: [YOUR COMPANY ADDRESS]
Contact Number: [YOUR COMPANY NUMBER]
Website: [YOUR COMPANY WEBSITE]
Social Media: [YOUR COMPANY SOCIAL MEDIA]
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