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PRECIPITATING INCIDENT SUMMARY REPORT

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Student Name

Student ID

Student DOB

John Doe

123456

10/03/2000

Infraction Details:
Date: 2/11/15

Time: 07:48

Location of Incident:

Infraction:

Weapons on School Campus

Quad

VICTIM(s):
WITNESS(es):

Bob Smith [Grade 8 #1234567]; Joe Bob [Grade 6 #12345678]; Guy Man [Grade 8 #123456789]

SUMMARY:
On Wednesday, February 11, 2015, Joe Bob [Grade 6 #12345678] was with John Doe [Grade 8 #123456] at the bus loading
area. Joe Bob [Grade 6 #12345678] believes he saw a knife in John Doe's [Grade 8 #123456] backpack. He did not report
the incident immediately, but wrote a witness statement when asked detailing what he saw.
Bob Smith [Grade 8 #1234567] and Joe Bob [Grade 6 #12345678] observed three students sitting on the ground. They
witnessed John Doe [Grade 8 #123456] pull out a silver knife and flip the blade out. Bob Smith [Grade 8 #1234567] asked
the student what his name was. The student replied "JD" John Doe [Grade 8 #123456]. Bob Smith [Grade 8 #1234567]
then walked over to the dean's office.
On Wednesday, February 11, 2015, Bob Smith [Grade 8 #1234567], entered the dean's office at approximately 7:30am. He
informed Jane Teacher, teacher, that a student named "JD" had a knife on campus and was wearing a red hat. Teacher
Jane Teacher had Bob Smith [Grade 8 #1234567] fill out an incident report while she contacted CCSD Police Officer Bob.
Officer Bob proceeded to search the courtyard looking for a student with a red hat. Officer Bob and teacher Sam Smith
located John Doe [Grade 8 #123456] in the quad near the cafeteria. Officer Bob asked John Doe [Grade 8 #123456] if he
had a knife on him, and John Doe [Grade 8 #123456] said that he did and pointed to the zipper pocket of his backpack.
Officer Bob found the knife and proceeded to escort John Doe [Grade 8 #123456] to his office. At this time, Officer Bob took
pictures of the knife and filed a police report [#1502-01049]. John Doe [Grade 8 #123456] was placed on required parent
conference.
John Doe [Grade 8 #123456] is an eighth grader [8] at Swainston Middle School. He has been referred to the office three
times prior this incident- once for classroom disruption, once for hitting another student, and once for unacceptable school
behavior, all resulting in required parent conferences. He is currently on suspension for the current incident (Weapons on
School Campus).
A conference was held on Wednesday, February 18, 2015 with father Mr. Senior Doe and Dr. Lucy Lucison, Administrator
on Special Assignment. Dr. Lucison informed Mr. Senior Doe that the administration was recommending expulsion for the
possession of a weapon. The levels of due process were explained to Mr. Senior Doe. Senior Doe AGREED with the
recommendation of expulsion. Mr. Senior Doe signed due process papers. John Doe [Grade 8 #123456] signed
suspension form. Homework was requested for John Doe [Grade 8 #123456].

The administration of Swainston Middle School has determined that John Doe [Grade 8 #123456] behavior is contrary to the
policies and regulations governing the students of the Clark County School District and Swainston Middle School.
Accordingly, the administration of Swainston Middle School is recommending that John Doe [Grade 8 #123456] be expelled
for violation of regulation 5141.1,specifically item I weapons.

Susan Tsukamoto
Admin on Special Assignment
Prepared By: ________________________________________
Title: ___________________________
Print Name

Signature: __________________________________________ Date: ___________________________

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PRECIPITATING INCIDENT SUMMARY REPORT (Continued)

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SUMMARY (Continued):

Signature: __________________________________________ Date: ___________________________