Incident Report Format Letter



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Incident  Report   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  1st   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/carol-­‐stream-­‐il/60188/weather-­‐warnings/328773ID  for  last,   and  spoke  with  him  privately  requesting  to  keep  his  behavior  in  check  so  that  no  problems   would  arise..




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