MIDDLE/HIGH SCHOOL - Action Snapshot Campaign WORKSHEET – Safe School Ambassadors®

Name of School: Otay Ranch Highschool City: San Diego State: CA PERIOD: From: 07/27/23 To 08/16/23 Page______ of ______
(MM/DD/YY) (MM/DD/YY)

# People Type of Mistreatment Type of Intervention / Action Taken

Date Invol Byst Exclus Put Intim Physical Acts Distract Balance Reason Support Direct Listen Get
Downs against Help
Campus
1. 07/28 2 1
2. 07/29 3 10
3. 07/29 2 2
4. 07/29 2 1
5. 07/30 2 3
6. 07/30 4 2
7. 08/1 2 4
8. 08/2 3 2
9. 08/3 4 3
10. 08/4 2 1
11. 08/5 3 2
12. 08/5 4 2
13. 08/4 2 10
14. 08/10 2 1
15. 08/10 3 1
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
Sub Totals

Total Number of Interventions this page: 15 Completed By: J'orDyn Rucker

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