____________________________________________________________________. ____________________________________________________________________. Names of Witnesses: _________________________________________________. Actions Taken: ________________________________________________. ____________________________________________________________________. Signed (Employee): _________________________________ Signed Principal:__________________________________________ Date: _________________________. Note: It should be noted that the term injury relates to all injuries, however slight, whether accidental or as a result of an incident. APPENDIX V Appendix 1- PHYSICAL INTERVENTION INCIDENT REPORT FORM. All physical restraints have to be documented by all staff who were involved in or who witnessed the restraint. Who was involved? Where did it take place?
____________________________________________________________________. ____________________________________________________________________. Names of Witnesses: _________________________________________________. Actions Taken: ________________________________________________. ____________________________________________________________________. Signed (Employee): _________________________________ Signed Principal:__________________________________________ Date: _________________________. Note: It should be noted that the term injury relates to all injuries, however slight, whether accidental or as a result of an incident. APPENDIX V Appendix 1- PHYSICAL INTERVENTION INCIDENT REPORT FORM. All physical restraints have to be documented by all staff who were involved in or who witnessed the restraint. Who was involved? Where did it take place?
School%20Plan%20Section%204.1.3%20%20Code%20of%20Behaviour.docx