Restraint and Seclusion Report

Field

Description

Select Schools

If run at the district level, choose one of the following:

• Select Multiple Schools – Select schools to include in the report. To select a single school, click that school. To select multiple schools, use Ctrl+Click and select each school to be included.

• All Schools – Run the report for the entire district.

If run at the school level, the report includes all records associated with the current school that meet the selection criteria. To change the current school, click School at the top of the page and choose the appropriate school from the list.

Select Students

Indicate which students to include in the report by selecting one of the following options:

• The selected [number] students only – Run the report for selected students only.

• All students – Run the report for all students in the current school or district who meet the selection criteria.

Note: If running the report for a single student or a group of students, select the students prior to running report.

Report Start Date

Enter the start date for the reporting period.

Report End Date

Enter the end date for the reporting period.

1

School District Name

The name of the reporting LEA.

[Prefs]Value

[Prefs]Name = districtname

N/A

2

Date

The date the report was run.

N/A

N/A

3

Printed name of person completing the report

The name (Last, First) of the staff member completing the report.

[Prefs]Value

[Prefs]Name = superintendent

150

4

Phone

The main phone number for the LEA.

[Prefs]Value

[Prefs]Name = districtphone

12 

5

Signature

Signature line for the superintendent or reporter.

N/A

N/A

6

Total number of incidents involving the restraint or seclusion of a student:

The total number of incidents involving the restraint or seclusion of a student. 

[S_AK_LOG_CRDC_X]PhysRestraint

[S_AK_LOG_CRDC_X]MechRestraint

[S_AK_LOG_CRDC_X]Seclusion

N/A

7

Number of incidents that resulted in injury or death of students or personnel:

The number of incidents that resulted in injury or death of students or personnel.

[S_AK_LOG_VICTIM_C]Injured

[S_AK_LOG_VICTIM_C]VictimType = Student

N/A

8

Number of incidents in which school personnel involved in the restraint or seclusion were not trained in an approved crisis intervention training program as described in AS 14.33.127(b):

The number of incidents in which school personnel involved in the restraint or seclusion were not trained in an approved crisis intervention training program as described in AS 14.33.127(b):

[S_AK_LOG_VICTIM_C]VictimType = Staff

[S_AK_USR_X]RcvdCrisisTrng

N/A

9

Number of incidents involving the restraint or seclusion of a child with a disability under AS 14.30.350. The report must also include the category of the disability of the child involved in each incident.

The number of incidents involving the restraint or seclusion of a child with a disability under AS 14.30.350. See below for the category of the disability of the child involved in each incident.

[S_AK_LOG_CRDC_X]PhysRestraint

[S_AK_LOG_CRDC_X]MechRestraint

[S_AK_LOG_CRDC_X]Seclusion

AND

[S_AK_LOG_X]SpEdIndicator = Y

OR

[S_AK_LOG_X]SpEdIndicator = Y

AND

[S_AK_STU_X]Transfer_GE_Date >=[S_AK_LOG_X]Incident_Date

N/A

10

Cognitive Disability/Intellectual Disability

The number of incidents involving a child with a cognitive or intellectual disability.

[S_AK_STU_X]Disability_Code = 2

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

11

Specific Learning Disability/Learning Disability

The number of incidents involving a child with a learning disability.

[S_AK_STU_X]Disability_Code = 9

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

12

Emotional Disturbance

The number of incidents involving a child with an emotional disturbance disability.

[S_AK_STU_X]Disability_Code = 6

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

13

Deafness

The number of incidents involving a child with deafness.

[S_AK_STU_X]Disability_Code = 3

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

14

Deaf-Blindness

The number of incidents involving a child with deaf-blindness.

[S_AK_STU_X]Disability_Code = 10

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

15

Hearing Impairment

The number of incidents involving a child with a hearing impairment.

[S_AK_STU_X]Disability_Code = 3

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

16

Orthopedic Impairment

The number of incidents involving a child with an orthopedic impairment.

[S_AK_STU_X]Disability_Code = 7

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

17

Other Health Impairment

The number of incidents involving a child with another health impairment.

[S_AK_STU_X]Disability_Code = 8

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

18

Speech or Language Impairment

The number of incidents involving a child with a speech or language impairment.

[S_AK_STU_X]Disability_Code = 4

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

19

Visual Impairment

The number of incidents involving a child with a visual impairment.

[S_AK_STU_X]Disability_Code = 5

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

20

Multiple Disabilities

The number of incidents involving a child with multiple disabilities.

[S_AK_STU_X]Disability_Code = 14

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

21

Autism

The number of incidents involving a child with autism.

[S_AK_STU_X]Disability_Code = 13

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4

22

Traumatic Brain Injury

The number of incidents involving a child with a traumatic brain injury.

[S_AK_STU_X]Disability_Code = 13

AND

[S_AK_STU_X]Transfer_GE_Date = blank or >= [S_AK_LOG_X]Incident_Date

4