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Series 405.7.6.4P - Follow-up Report on Complaint of Harassment, Discrimination, Violence or Hazing

 

To:         Human Rights Officer:

              Director of Human Resources (concerns relating to personnel conduct)

              Director of Elementary Education (concerns relating to student conduct, grades K-5)

              Director of Secondary Education (concerns relating to student conduct, grades 6-12)

              Director of Special Education (concerns relating to a student’s disability, including their rights under Section 504)
                                                                 

From:                                               , Principal/Designee/other  (circle one)

                                                                  

____________________________________________ , _______________________________

                                                Position                                                            School

Date:______________________________

 

Subject:  Fifteen-Day Follow-Up Report on Complaint of Harassment, Discrimination, Violence or Hazing

 

Approximately 15 days ago I completed the investigation of a complaint based on
(check all that apply):

□  race                            □  national origin           □  marital status

□  religion                        □  sex                            □  creed

□  sexual orientation        □  age                           □  disability

□  color                            □  hazing (of a student)   □  familial status

□  status with regard to public assistance                □  genetic information

□  membership or activity in a local human rights commission

harassment, discrimination, violence or hazing from                                            

(student/district personnel) in which I found that the complaint was substantiated.

(circle one)

I have checked with the complainant to determine if the harassment, discrimination, violence or hazing has ceased or if it continues. He or she reports that it has:                               ceased                             continues

I would also like to inform you that                                                                          

                                                                                                                            

                                                                                                                            

Signature of Investigator X                                                               Date               

Signature of Complainant X                                                             Date               

Procedure/405.7.6.4P/11-21-16