coumv SPECIAL EDUCATION LOCAL PLAN AREMSELP BEHAVIOR EMERGENCY REPORT amt m'slnhuunnolws mumanme sanctum j: 3' I - oggqfieg}; Last Name: Name: IL Agfi 'Dale Report? fi 13/ Dale DI Inside"): kg (95% 1; Tame mm Tune Incident Ended: . Dislriclamgemance: 2'92) oanidem: Bum 2 1 District or Hesidence: School: Tig\ (Lin, bewh sown mt: Gomplele [arm lad . . 4A4 civdg'ollv 4/wa \4 I fig; OM peach] +'w9 Wik'fi Puma mammal; . Lag UmUime) 3 "a 1] Omar physical conla'inmen'l (desbrmef (length of lime) 5 vaam, wan n'ame(s) and posilions(s) al start/otth involved (L W'Wfii - No observable lies or lnlurlas sustained by student . WNW par bad; 09 egg? er um ca:%0\ bu,an )0 '31"244% Copy pieced in smdenlfila (on she and a! Dime: omce) Egg sent to Behaworln|ewerilfon Case Manager Copy sent to SELPA 011198 (within 5 days a! incident) RIVERSIDE COUNTY LBCAL PLAN AREA BEHAVIOR EMERGENCY REPORT- ImmunAn-a Check S|uden'l dues nul haves mire!" Behavior Inlervenlion Plan. lwo days unhe behavioral emergency, designaled responsible adlninldzalgr shall admdule-an IEP Kneeling lo rpyiew emergency rayon in delermine lhe necessin fdra (undinnalanalys's assessment. and lo determine the need luran inmn'm . - 1 figment has an sxisu'ng Pasflive Egnaviur Intervention Plan 'wious behaviorpvohlem occurs or when a pleviuusly design . shalmonvene '0 reviewva imidsnl and fl mere Dnszibc Including evenxs max led up lo mo emaeganw ~H~ua was a" 4(1) [v.vmh . N42, my "Lot--u at HAW woven 0H w'mmvi' 1a.; 47) gszYiJS't 'n I fit) bwfig gamma! 1 3 wen.>> vfrexz mM'afiV ,5 4 {Mb} A 5 on a mum; Wi+3'\ 1; 'sr ml: a marl. "911 Erie well 'w'dfie "315 CanMd Kai) (ab arms (35+be ,ogen bawdy; M6 was alarm? kaM ad 56? on wausdw mama \wf'r room wgPifif' '05! (a Wm war