Eec Incident Action Plan printable pdf download

INCIDENT ACTION PLAN

Regulation 606 CMR 7.11(5)(f)

(Behavioral Incidents, Accidents, Property Destruction, Emergencies)

It is important for administrators and educators to identify the reasons why a child may be exhibiting certain types

of behavior through the process of evaluating the program’s environment, transitional patterns, triggering

behavioral patterns, and the quality interactions between child and educators. This preventative tool begins the

process of working with a child and their parents to identify concerns and offer solutions to assist the child in

integrating successfully into the program and when appropriate, offering referrals. EEC recommends that

program administrators and educators meet with parents as soon as an issue is identified to build a partnership of

trust and to avoid suspension and termination.

Child’s Name: _____________________________________________________________________________________

Date of Incident: ______________________________________Time of Incident: _______________________________

Description of Incident (be specific):____________________________________________________________________

__________________________________________________________________________________________________

Is this the first time this incident occurred, if not when was the last time it occurred? ______________________________

__________________________________________________________________________________________________

Is this child receiving any additional services? ____________________________________________________________

__________________________________________________________________________________________________

Was there something different about the child’s day that led to the incident occurring? ____________________________

__________________________________________________________________________________________________

What actions could the program take to prevent this incident from occurring? ___________________________________

__________________________________________________________________________________________________

What actions did the educator take immediately preceding the incident? ________________________________________

__________________________________________________________________________________________________

Page 1 of 2

SG/LG/SAIncidentPlan20100920

Eec Incident Action Plan