This narrative should include the following four elements: 1) a summary of each individual allegation, 2) a summary of the accused’s response to each individual allegation, 3) relevant investigative facts (i.e., witness interviews, documentation collected, etc.), and 4) the finding, whether the allegation of bullying/harassment is founded or unfounded.
Did this act or conduct (check those that apply):*
Place the student in reasonable fear of harm to the student’s person or property? If yes, explain how
Have a substantially detrimental effect on the student’s physical or mental health? If yes, explain how
Have the effect of substantially interfering with the student’s academic performance? If yes, explain how
Have the effect of substantially interfering with the student’s ability to participate in or benefit from the
District services, activities or privileges? If yes, explain how.
*In order to objectively create a hostile school environment, the totality of circumstances must be considered and typically a single or isolated instance will not rise to the level of meeting these four conditions unless the incident complained of was considered severe in nature (i.e., causing physical injury or serious bodily harm).
Was this incident founded? Yes No
Date Summary Report sent to complainant and parent/guardian of the alleged target
Date Summary Report sent to parent/guardian of the accused
Any additional follow up action to be take:
Signed by , Date
(Investigator)
Signed by , Date
(Building Administrator)
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