District Code: ____________________ Intervention Services: Description of Intervention Person(s) Responsible Timeline for Implementation Service Implementation Complete Training Programs: Description of Training Person(s) Responsible Timeline for Implementation Program (Specific) Implementation Complete Counseling: Description of Counseling Person(s) Responsible Timeline for Implementation Service Implementation Complete Discipline: Description of Discipline Person(s) Responsible Timeline for Implementation Implementation Complete Other: Description of Other Action Person(s) Responsible Timeline for Implementation Recommended or Taken Implementation Complete COMMENTS: ________________________________________________________ ___________________________________ Principal Signature Date Date Submitted to Superintendent** within two (2) school days of the completion of the investigation. ** The Principal must submit this Report to the Superintendent Summary of Recommendations Superintendent’s District Code: ___________________________ ______ No further action(s) required at this time ______ The following is recommended: _____________________________________________________ ______________
District Code: ____________________ Intervention Services: Description of Intervention Service Person(s) Responsible Timeline for Implementation Implementation Complete Training Programs: Description of Training Program (Specific) Person(s) Responsible Timeline for Implementation Implementation Complete Counseling: Description of Counseling Service Person(s) Responsible Timeline for Implementation Implementation Complete Discipline: Description of Discipline Person(s) Responsible Timeline for Implementation Implementation Complete Other: Description of Other Action Recommended or Taken Person(s) Responsible Timeline for Implementation Implementation Complete COMMENTS: ________________________________________________________ ___________________________________ Principal Signature Date Date Submitted to Superintendent** ** The Principal must submit this Report to the Superintendent within two (2) school days of the completion of the investigation. Superintendent’s Summary of Recommendations District Code: ___________________________ ______ No further action(s) required at this time ______ The following is recommended: _____________________________________________________ ______________
HIB%20Forms%20(Reporting%20Investigation%20Summary).docx