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Impaired Behavior Incident Report Form - City of Oak Harbor

Impaired Behavior Incident Report Form - City of Oak Harbor 2025

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The document is an Impaired Behavior Incident Report Form designed for supervisors to document observations that may necessitate a reasonable suspicion drug and/or alcohol test for covered employees. It outlines the required observations regarding the employee's appearance, behavior, speech, and body odors, which must be recorded within 24 hours of the incident. The form includes sections for detailing the incident, witness information, and specific physical and behavioral indicators of impairment. It emphasizes confidentiality and mandates attachment to relevant testing forms.

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What is a behavior incident report?

A Behavior Incident Report is a structured risk management document used to record and document details surrounding an incident or behavior that deviates from established norms or expectations in an organization.

How do you write a behavior incident report?

How to Write an Incident Report: A Step-by-Step Guide (with Examples) Step 1: Provide Fundamental Information. Step 2: Take Note of Any Damages and Injuries. Step 3: Identify Affected Individual(s) Step 4: Identify Witnesses and Take Their Statements. Step 5: Take Action. Step 6: Close Your Report.

How do you write an incident report example?

Three Incident Report Samples Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event. Whether or not proper PPE was being used.

How do you write a bad behavior report?

Tips for Documenting Incidents Write about the facts: the who, what, where, when, and how. Include the impact of the behavior. Describe any attempts to intervene, discuss, or mitigate the issue and how the person responded to that.

What is an example of a behavior incident?

Persistent, repeated inappropriate behavior can become a form of harassment and thereby become disruptive, and subject to treatment as disruptive behavior. Examples include, but are not limited to: Belittling or berating statements Name calling Use of profanity or disrespectful language Inappropriate comments

What to write in a behavior report example?

The ABCs of Documentation: About the Person (name, student identification, relationship to the University) Behaviors Observed (body language, words, tone of voice, actions) Context (when, what class did this take place in, where on campus, any unique factors of the setting)

Impaired Behavior Incident Report Form - City of Oak Harbor 2025

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