HTML Preview Incident Report Format Letter page number 1.


Incident(Repo rt(
Date:!02/26/13!
Time:((8:30pm!
Concerning:!!149599!
Staff(Involved:((Case!Manager!!
Location:((1st!Church!of!Lombard!
Statement(of(Facts:(
On!the!above!date!and!approximate!time!this!Case(Manger!was!working!the!night!site!at!1
st
!
Church!when!the!verbal!confrontation!between!program(participant!and!CM!initially!started.!!
Earlier!in!the!evening!this!CM!observed!pp!highly!intoxicated,!so!CM!held!on!to!his!pads!
http://m.accuweather.com/en/us/carolKstreamKil/60188/weatherKwarnings/328773ID!for!last,!
and!spoke!with!him!privately!requesting!to!keep!his!behavior!in!check!so!that!no!problems!
would!arise.!!Pp!ignored!CM!and!stumbled!into!the!site.!!CM!sensed!that!there!was!going!to!be!
a!problem!with!pp!based!on!his!facial!expression,!and!decided!to!monitor!his!behavior.!!For!the!
most!part,!pp!was!quiet!and!simply!starring!at!CM!with!resentment.!!CM!then!took!the!
opportunity!to!inform!pp!that!the!document!he!requested!(last!week!Thursday!02/21/13)!for!
his!probation!officer!was!ready!and!waiting!for!him!at!the!Support!Center.!!Pp!responded!that!
he!needed!that!document!for!this!week,!and!that!if!he!goes!to!jail!for!not!having!it,!that!he!is!
going!to!make!CM!pay.!!CM!then!stated!to!pp!that!if!it!was!very!important!to!him,!then!he!
should!have!waited!for!CM!until!the!task!was!completed,!and!this!way!he!would!have!had!it.!!
Instead,!pp!left!the!Support!Center!with!another!pp!(female),!as!if!it!did!not!have!any!
importance.!!Pp!started!using!negative!language!towards!CM,!and!CM!then!walked!away!
deciding!to!disengage!as!pp!was!not!just!intoxicated,!but!emotionally!disturbed!as!well.!!A!few!
minutes!later,!CM!was!sitting!with!Staff!(JD),!and!pp!decided!to!approach!and!continue!the!
conversation!by!casting!threats!towards!CM.!!CM!informed!pp!to!let!it!go,!and!get!some!rest!at!
his!pad.!!However,!pp!stated!that!the!only!way!he!was!going!to!let!it!go!was!by!engaging!in!a!
physical!confrontation!with!CM.!!CM!informed!pp!that!what!he!was!requesting!is!not!going!to!
happen,!but!that!he!needed!to!give!CM!some!space,!otherwise,!the!police!will!be!contacted!to!
have!pp!escorted!out!from!the!premises.!!Pp!stated!that!he!didnt!give!a!fuck!about!the!
police,!and!that!he!would!have!CM!on!the!floor!before!the!police!got!there.!!Pp!then!started!
talking!about!his!past!gang!history!and!his!time!spent!in!prison.!!Then!pp!started!talking!jargon!
mentioning!how!he!was!going!to!take!legal!action!against!PADS!(CM!and!IHC),!and!how!he!had!
everything!recorded!and!documented,!but!did!not!say!anything!in!specific.!!Staff!attempted!to!
intervene,!but!pp!was!being!disrespectful!to!her!as!well!by!acknowledging!staff!as!sexy.!!CM!
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