Revised April 2011

Bullying Prevention and Intervention Plan
Table of Contents
Introduction………………………………………………………………..Page 1
Executive Summary ………………………………………………………Page 2
Goals of the Bullying Prevention and Intervention Plan ………………Page 3
Definitions………………………………………………………………….Page 4
Policy Scope………………………………………………………………..Page 6
Building the Foundation and Framework……………………………….Page 7
Bullying, Antidiscrimination, and Harassment Policies………………...Page 8
Implementation Procedures ……………………………………………..Page 19
Learning the Guidelines…………………………………………………Page 22
Working Together………………………………………………………..Page 24
Measuring Our Progress………………………………………………...Page 27
Appendices………………………………………………………………..Page 31

Rowe School District expects that all members of the school community will treat one another in a civil, respectful manner. The District is committed to providing and maintaining a safe, secure, and positive school climate and culture. This positive culture will increase student engagement and promote academic achievement. The
District will purposefully build a kind, inclusive community.
The District will create a safe environment for all students and will teach all students strategies to prevent and respond to teasing, bullying, and harassment. We will teach pro-social values through our social skills curriculum and teachers, staff, and administrators will be role models of ethical behavior.
The District understands that members of certain student groups such as students with disabilities, students who identify as gay or lesbian, or racial minorities may be more vulnerable to becoming targets or aggressors. Teachers and staff will monitor vulnerable students and provide additional support, as needed.
The District will not tolerate unlawful or disruptive behavior including bullying, cyberbullying, harassment, or retaliation in school buildings, on school grounds, or at school-related activities. We will promptly investigate all bullying reports, take prompt action to stop bullying behavior, and restore a sense of safety for targets.
The District is committed to working with students, staff, families, law enforcement agencies, and the community to prevent bullying. We have established this Bullying Prevention and Intervention Plan to prevent, intervene, and respond to incidents of bullying, cyberbullying, harassment, and retaliation. The Superintendent of Schools and the principals are responsible for implementing, enforcing, and reviewing and revising the Plan annually.
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The Rowe School District’s Bullying Prevention and Intervention Plan is based in part on surveys of four constituencies, students in grades 3-6, students in grades 7-12, teachers, administrators, and staff, and parents. Surveys were available online and were completed between September 10 and October 9, 2010. Over 50% of each constituent group completed surveys.
Here are the key findings of the surveys. Percentage points are rounded to the nearest percent. The percentages are percentages of respondents.
Key Findings

70% of middle and high schools students report they had not been bullied at school.

87% of parents think their child’s school does an average to excellent job of making school a safe place.

60% of parents report their children always feel safe at school.

96% of teachers, staff, and administrators agree that Student Handbooks are used to disseminate the District’s Bullying Policy.

85% of teachers, staff, and administrators report that parents/guardians are notified within 24 hours when a bullying incident occurs.

60% of elementary students did not tell anyone when a bullying incident occurred.

36% of parents say their child has been bullied at school.

30% of parents say that school rules of conduct are only sometimes enforced.

38% of parents have never been invited to participate in an anti-bullying program at their child’s school.

87% of teachers and staff say they hold conferences with bullies as a consequence of bullying and 75% issue a warning, two of the most frequently used interventions.
The survey data the District gathered indicates that teachers, administrators, staff, parents, and students have work to do.
Next Steps
 All students need to be encouraged to respond and report bullying.

Teachers and staff need to learn the process for reporting and investigating incidents so they can share responsibility with their principals.

Teachers, administrators, and staff need to consistently enforce rules of conduct.

Teachers, administrators, and staff may want to explore additional interventions for bullies, including making amends, restorative justice, and community service.

The District needs to organize and implement parent education programs about bullying and other related parenting issues.
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The goals of the Bullying Prevention and Intervention Plan are to:

Create and maintain a safe and positive school climate.

Define what constitutes bullying and harassment.
 Reinforce the District’s commitment to investigate and respond to bullying and harassment.
 Develop procedures to respond to bullying and harassment reports.
 Clarify disciplinary actions and the extent to which Rowe School District administrators must respond according to District policies and procedures.
3

Bullying is defined as victimization, intimidation or mistreatment of an individual by other(s), based on physical, psychological, or social power or perceived power. Bullying includes cyberbullying and may constitute a crime. Bullying includes behavior that may cause physical and/or emotional harm, and such behavior is unwelcome, intentional, and usually repeated. Bullying can be verbal, physical, direct or face-to-face, or indirect, for example, through another person or in written form. Bullying is generally a pattern of behavior directed at another individual , rather than a single, isolated incident. Bullying does not include harassment .
Bullying is repeated abuse by any member of the District community. It may be written, visual, verbal, or electronic. It may be a physical act or gesture. Behavior is considered bullying if it does any of the following:
 causes physical or emotional harm to the target or damage to the target’s property 



 places the target in reasonable fear of harm to him/herself, or of damage to his/her property  creates a hostile environment at school for the target  infringes on the rights of the target at school  materially and substantially disrupts the education process or the orderly operation of a school.

Harassment is unwelcome, intentional, discriminatory behavior toward an individual or group motivated by real or perceived membership in a protected category including race, ethnicity/national origin, religion, disability, gender, sexual orientation, or age.
Sexual Harassment is a sexual advance, request for sexual favor, or behavior of a sexual nature when:
1.
submission to or rejection of such advance, request, or behavior is made either explicitly or implicitly a term or condition of employment, or as a basis for employment decisions, or decisions regarding student evaluation, or participation in school programs or activities, OR
2.
sexual advance, request, or behavior that has the purpose or effect of unreasonable interfering with an individual’s work or school performance by creating an intimidating, hostile, humiliating, or sexually offensive environment.
Sexual harassment may occur student to student, adult to student, student to adult, adult to adult, male to female, female to male, male to male, and/or female to female.
Cyberbullying is any willful, single or repeated harm through, but not limited to, Web pages, social networking sites, email, instant messaging or text messaging using computers, cell phones and other electronic devices. Cyberbullying is intentional and results in social/emotional harm and distress, for example:
4


Sending offensive or threatening text messages over the Internet by computer, cell phone, or electronic network

Posting offensive or threatening text, images, audio, or video to a Web page, through a cell phone or electronic network, including social networking sites
 Sending a threatening intimidating, graphic or sexually explicit photo or video via the Internet, or using a cell phone or electronic network, including social networking sites
Cyber-harassment is willful and repeated harm inflicted through but not limited to, Web pages, social networking sites, email, instant messaging or text messaging using computers, cell phone, or electronic network, when the target is an individual or individuals who are members of a protected group, either real or perceived.
Hazing is any behavior or method of initiation into a student organization, whether on public or private property, which willfully endangers the physical or mental health of any individual. Such behavior includes beating, whipping, branding, forced calisthenics, exposure to weather, forced consumption of any food, liquor, beverage, drug, or other substance, or any other brutal treatment or forced physical activity which is likely to adversely affect the health and safety of an individual or which subjects an individual to extreme mental stress, including sleep deprivation, or extended isolation. Hazing is a form of bullying.
Retaliation is any form of intimidation, reprisal, or harassment by a school community member directed against another school community member, for reporting or filing a complaint, for aiding the filing of a report or complaint, for cooperating in an investigation, or for taking action consistent with this policy.
School community is a group of individuals who are connected with District schools including students, teachers, administrators, paraprofessionals, parents, coaches, school committee and local educational council members, and interested townspeople.
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Bullying, cyberbullying, harassment or cyber-harassment is prohibited in classrooms, on school premises, immediately adjacent to school premises, traveling to and from school, or at school-sponsored events, whether or not the events are held on school premises.
Traveling to and from school includes on a school bus or other school vehicle, at school bus stops, and walking to and from school within a reasonable time before and after school.
Bullying or harassment, including cyberbullying and cyber-harassment, can occur in locations not mentioned above, if the incident results or could result in substantial disruption of the school learning environment or orderly day-to-day operation of the school.
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Leadership
The following leaders will be responsible for implementing and enforcing the
District’s Bullying Prevention and Intervention Plan:
District Equity Officer – The Superintendent of Schools has primary responsibility for enforcing the Plan at the district level and serves as District
Equity Officer. He/she handles public and media relations and is the spokesperson for the district. The District Equity Officer is aware of all bullying incidents and investigations.
School Equity Officer – The principals have primary responsibility for enforcing the Plan at the school level. They handle incidents and investigations. They report to the District Equity Officer. They are responsible for gathering and maintaining data about bullying and harassment incidents at their schools.
Chiefs of Police – The chiefs of police of each of the towns within the District consult with the District as needed.
Data Manager – A data manager maintains records of all bullying incidents and investigations for the District. He/she monitors data and reports to the District
Equity Officer. District professional development and parent education programs will be planned based on data received.
Anti-Bullying Leadership Team – The Anti-Bullying Leadership Team is composed of students, teachers, parents, administrators, staff, law enforcement officers, community-based agencies, and community members who are appointed to serve, and whose purpose is to oversee annually the implementation and progress of the Plan. The Anti-Bullying Leadership Team may recommend to the
District Equity Officer that revisions be made in the Plan.
Rowe School District policies that address bullying, harassment, and antidiscrimination are:

Bullying Prevention Policy

Non-Discrimination Policy

Non-Discrimination on the Basis of a Disability Policy

Sexual Harassment Policy
The text of these District policies is included below on pages 8 through 18.
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JICFB
The Rowe Public School is committed to providing a safe, positive and productive educational environment where students can achieve the highest academic standards. No student shall be subjected to harassment, intimidation, bullying, or cyberbullying.
“Bullying” is the repeated use by one or more students of a written, verbal, or electronic expression, or a physical act or gesture, or any combination thereof, directed at a target that:

 causes physical or emotional harm to the target or damage to the target’s property; places the target in reasonable fear of harm to him/herself, or of damage to his/her property;
 creates a hostile environment at school for the target;
 infringes on the rights of the target at school; or
 materially and substantially disrupts the education process or the orderly operation of a school.
“Cyber-bullying” means bullying through the use of technology or any electronic communication, which shall include, but shall not be limited to, any transfer of signs, signals, writing, images, sounds, data or intelligence of any nature transmitted in whole or in part by a:

 wire
 radio electromagnetic
 photo-electronic or photo-optical system, including, but not limited to, electronic mail, internet communications, instant messages or facsimile communications.
Cyber-bullying shall also include the creation of a web page or blog in which the creator assumes the identity of another person or knowingly impersonates another person as author of posted content or messages, if the creation or impersonation creates any of the conditions enumerated in the definition of bullying.
Cyber-bullying shall also include the distribution by electronic means of a communication to more than one person or the posting of material on an electronic medium that may be accessed by one or more persons, if the distribution or posting creates any of the conditions enumerated in the definition of bullying.
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Bullying and cyber-bullying may occur in and out of school, during and after school hours, at home and in locations outside of the home. When bullying and cyber-bullying are alleged, the full cooperation and assistance of parents and families are expected.
For the purpose of this policy, whenever the term bullying is used it is to denote either bullying, or cyber-bullying.
Bullying is prohibited:
 On school grounds;
 On property immediately adjacent to school grounds;
 At school-sponsored or school-related activities;


At functions or programs whether on or off school grounds;
 At school bus stops;
On school buses or other vehicles owned, leased or used by the school district; or,
 Through the use of technology or an electronic device owned, leased or used by the Rowe public school.
Bullying and cyber-bullying are prohibited at a location, activity, function or program that is not school-related or through the use of technology or an electronic device that is not owned, leased or used by the Rowe School District if the act or acts in question:


 create a hostile environment at school for the target; infringe on the rights of the target at school; and/or materially and substantially disrupt the education process or the orderly operation of a school.
Prevention and Intervention Plan
The Superintendent and/or his/her designee shall oversee the development of a prevention and intervention plan, in consultation with all district stakeholders, which may include teachers, school staff, professional support personnel, school volunteers, administrators, community representatives, local law enforcement agencies, students, parents and guardians, consistent with the requirements of this policy, as well as state and federal laws. The bullying prevention and intervention plan shall be reviewed and updated at least biennially.
The Principal is responsible for the implementation and oversight of the bullying prevention and implementation plan within the Rowe Public School.
Reporting
Students, who believe that they are a target of bullying, observe an act of bullying, or who have reasonable grounds to believe that these behaviors are taking place, are
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obligated to report incidents to a member of the school staff. The target shall, however, not be subject to discipline for failing to report bullying.
The Rowe Public School shall have a means for anonymous reporting by students of incidents of bullying. No formal disciplinary action shall be taken solely on the basis of an anonymous report.
Any student who knowingly makes a false accusation of bullying shall be subject to disciplinary action.
Parents or guardians, or members of the community, are encouraged to report an incident of bullying as soon as possible.
A member of the school staff shall immediately report any instance of bullying the staff member has witnessed or become aware of to the school principal or their designee.
Investigation Procedures
The Principal or their designee, upon receipt of a viable report, shall promptly contact the parents or guardians of a student who has been the alleged target or alleged aggressor of bullying. The actions being taken to prevent further acts of bullying shall be discussed.
The school principal or a designee shall promptly investigate the report of bullying, using a Bullying/Cyber-bullying Report Form which may include interviewing the alleged target, alleged aggressor, staff members, students and/or witnesses.
Support staff shall assess an alleged target’s needs for protection and create and implement a safety plan that shall restore a sense of safety for that student.
Confidentiality shall be used to protect a person who reports bullying, provides information during an investigation of bullying, or is witness to or has reliable information about an act of bullying.
If the school principal or a designee determines that bullying has occurred he/she shall take appropriate disciplinary action and if it is believed that criminal charges may be pursued against the aggressor, the principal shall consult with the Superintendent to determine if criminal charges are warranted. If it is determined that criminal charges are warranted, the local law enforcement agency shall be notified.
The investigation shall be completed within fourteen school days from the date of the report. The parents or guardians shall be contacted upon completion of the investigation and informed of the results, including whether the allegations were found to be factual, whether a violation of this policy was found, and whether disciplinary action has or shall be taken. At a minimum the Principal or his/her designee shall contact the parents or guardians as to the status of the investigation on a weekly basis.
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Disciplinary actions for students who have committed an act of bullying or retaliation shall be in accordance with district disciplinary policies.
The Rowe Public School shall document any incident of bullying that is reported per this policy and a file shall be maintained by the Principal or designee. A monthly report shall be provided to the Superintendent.
Confidentiality shall be maintained to the extent consistent with the school's obligations under law.
Retaliation
Retaliation against a person who reports bullying, provides information during an investigation of bullying, or witnesses or has reliable information about bullying shall be prohibited.
Target Assistance
The Rowe Public School shall provide counseling or referral to appropriate services, including guidance, academic intervention, and protection to students, both targets and aggressors, affected by bullying, as necessary.
Training and Assessment
Annual training shall be provided for school employees and volunteers who have significant contact with students in preventing, identifying, responding to, and reporting incidents of bullying.
Age-appropriate, evidence-based instruction on bullying prevention shall be incorporated into the curriculum for all Pre-K to 6 th
grade students.
Publication and Notice
Annual written notice of the relevant sections of the bullying prevention and intervention plan shall be provided to students and their parents or guardians, in age-appropriate terms.
Annual written notice of the bullying prevention and intervention plan shall be provided to all school staff. The faculty and staff shall be trained annually on the bullying prevention and intervention plan.
Relevant sections of the bullying prevention and intervention plan relating to the duties of faculty and staff shall be included in the school employee handbook.
The bullying prevention and intervention plan shall be posted on the Rowe Public
School’s website.
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REFERENCES: Massachusetts Department of Elementary and Secondary Education’s
Model Bullying Prevention and Intervention Plan
LEGAL REFS.: Title VII, Section 703, Civil Rights Act of 1964 as amended
Federal Regulation 74676 issued by EEO Commission
Title IX of the Education Amendments of 1972
603 CMR 26.00
MGL 71:37O
MGL 265:43, 43A
MGL 268:13B
MGL 269:14A
CROSS REFS.: AC, Nondiscrimination
ACAB, Sexual Harassment
JBA, Student-to-Student Harassment
JICFA, Prohibition of Hazing
JK, Student Discipline Regulations
First Reading: October 12, 2010
Second Reading: November 9, 2010
Adopted: November 9, 2010
Rowe School Committee
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Rowe School District has the responsibility to overcome, insofar as possible, any barriers that prevent children from achieving their potential. The Rowe Public School will do its part. This commitment to the community is affirmed by the following statements that the
School Committee intends to:
1.
Promote the rights and responsibilities of all individuals as set forth in the State and
Federal Constitutions, pertinent legislation, and applicable judicial interpretations.
2.
Encourage positive experiences in human values for children, youth and adults, all of whom have differing personal and family characteristics and who come from various socioeconomic, racial and ethnic groups.
3.
Work toward a more integrated society and to enlist the support of individuals as well as groups and agencies, both private and governmental, in such an effort.
4.
Use all appropriate communication and action techniques to air and reduce the grievances of individuals and groups.
5.
Carefully consider, in all the decisions made within the school system, the potential benefits or adverse consequences that those decisions might have on the human relations aspects of all segments of society.
6.
Initiate a process of reviewing policies and practices of the school system in order to achieve to the greatest extent possible the objectives of this statement.
The Committee's policy of nondiscrimination will extend to students, staff, the general public, and individuals with whom it does business; No person shall be excluded from or discriminated against in admission to Rowe Public School or in obtaining the advantages, privileges, and courses of study on account of race, color, sex, religion, national origin, sexual orientation or disability. If someone has a complaint or feels that they have been discriminated against because of their race, color, sex, religion, national origin, sexual orientation or disability, their complaint should be registered with the Title IX compliance officer.
SOURCE: MASC
LEGAL REFS.: Title VI, Civil Rights Act of 1964
Title VII, Civil Rights Act of 1964, as amended by the Equal
Employment Opportunity Act of 1972
Executive Order 11246, as amended by E.O. 11375
Equal Pay Act, as amended by the Education Amendments of 1972
Title IX, Education Amendments of 1972
Rehabilitation Act of 1973
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Education for All Handicapped Children Act of 1975
M.G.L. 71B:1 et seq. (Chapter 766 of the Acts of 1972)
M.G.L. 76:5; Amended 1993
M.G.L.76:16 (Chapter 622 of the Acts of 1971)
Board of Education Chapter 622 Regulations Pertaining to Access to Equal Educational Opportunity, adopted 6/24/75, as amended 10/24/78
Board of Education 603 CMR 26:00
Board of Education Chapter 766 Regulations, adopted 10/74, as amended through 3/28/78
CROSS REFS.: ACA- ACE, Subcategories for Nondiscrimination
GBA, Equal Opportunity Employment
JB, Equal Educational Opportunities
NOTE: This category is for a general policy covering all types of nondiscrimination and relating to students, staff, and others. Federal and state laws apply.
If a policy relates to staff only, to students only, or a particular form of nondiscrimination, it is better filed elsewhere. Appropriate codes for such statements are indicated by the cross-references.
Regulations pertaining to all forms of nondiscrimination -- or a procedure all persons can resort to for redress of grievances related to nondiscrimination -- would follow under code AC-R.
Law in most instances requires official School Committee approval of regulations in this area.
First Reading: November 9, 2010
Second Reading and Adoption: December 14, 2010
Rowe School Committee
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Title II of the Americans With Disabilities Act of 1992 requires that no qualified individual with a disability shall, because the Rowe School District (the District) facilities are inaccessible to or unusable by individuals with disabilities, be excluded from participation in, or be denied the benefits of the services, programs, and activities of the
District or be subject to discrimination. Nor shall the District exclude or otherwise deny services, programs, or activities to an individual because of the known disability of a person with whom the individual is known to have a relationship or association.
Definition: A "qualified individual with a disability" is an individual with a disability who, with or without reasonable modification to rules, policies, or practices, the removal of architectural, communication, or transportation barriers, or the provision of auxiliary aids and services, meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by the District.
Reasonable Modification: The District shall make reasonable modification in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability, unless the District can demonstrate that making the modifications would fundamentally alter the nature of the service, program, or activity.
Communications: The District shall take the appropriate steps to ensure that communications with applicants, participants, and members of the public with disabilities are as effective as communications with others. To this end, the District shall furnish appropriate auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity to participate in, and enjoy benefits of, a service, program, or activity conducted by the District. In determining what type of auxiliary aid or service is necessary, the District shall give primary consideration to the requests of the individuals with disabilities.
Auxiliary Aids and Services: "Auxiliary aids and services" includes (1) qualified interpreters, note takers, transcription services, written materials, assisted listening systems, and other effective methods for making aurally delivered materials available to individuals with hearing impairments; (2) qualified readers, taped texts, audio recordings, Braille materials, large print materials, or other effective methods for making visually delivered materials available to individuals with visual impairments; (3) acquisition or modification of equipment or devices and (4) other similar services and actions.
Limits of Required Modification: The District is not required to take any action that it can demonstrate would result in a fundamental alteration in the nature of a service, program, or activity or in undue financial and administrative burdens. Any decision that, in compliance with its responsibility to provide effective communication for individuals with disabilities, would fundamentally alter the service, program, or activity or unduly burden the District shall be made by the School Committee after considering all resources available for use in funding and operating the program, service, or activity. A written statement of the reasons for reaching that conclusion shall accompany the decision.
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Notice: The District shall make available to applicants, participants, beneficiaries, and other interested persons information regarding the provisions of Title II of the American
With Disabilities Act (ADA) and its applicability to the services, programs, or activities of the District. The information shall be made available in such a manner as the School
Committee and Superintendent find necessary to apprise such persons of the protections against discrimination assured them by the ADA.
Compliance Coordinator: The District shall designate at least one employee to coordinate its efforts to comply with and carry out its responsibilities under Title II of
ADA, including any investigation of any complaint communicated to it alleging its noncompliance or alleging any actions that would be prohibited under ADA. The District shall make available to all interested individuals the name, office address, and telephone number of the employee(s) so designated and shall adopt and publish procedures for the prompt and equitable resolution of complaints alleging any action that would be prohibited under the ADA. The Rowe School District receives federal financial assistance and must comply with the above requirements. Additionally, the School
Committee is of the general view that:
1.
Discrimination against a qualified handicapped person solely on the basis of handicap is unfair; and
2.
To the extent possible, qualified handicapped persons should be in the mainstream of life in the school community. Accordingly, employees of the school system will comply with the above requirements of the law and policy statements of this Committee to ensure nondiscrimination on the basis of handicap.
SOURCE: MASC
LEGAL REFS.: Rehabilitation Act of 1973, Section 504
Education For All Handicapped Children Act of 1975
M.G.L. 71B:1 et seq. (Chapter 766 of the Acts of 1972)
Title II, Americans with Disabilities Act of 1992
Board of Education Chapter 766 Regulations, adopted 10/74, as amended through 3/28/78
CROSS REFS.: IGB, Special Instructional Programs and Accommodations
IGBA, Programs for Handicapped Students
NOTE: Due to federal and state laws, many school committees are adopting policies and extensive regulations pertaining to Nondiscrimination on the
Basis of Handicap. At times, policy, regulations, and specific plans for action are combined in one long statement presented as policy. Other school systems present policy and regulatory statements separately.
First Reading: November 9, 2010
Second Reading and Adoption: December 14, 2010
Rowe School Committee
16

All persons associated with the Rowe Public School including, but not necessarily limited to, the committee, the administration, the staff, and the student, are expected to conduct themselves at all times so as to provide an atmosphere free from sexual harassment. Any person who engages in sexual harassment while acting as a member of the school community will be in violation of this policy. Further, any retaliation against an individual who has complained about sexual harassment or retaliation against individuals for cooperating in an investigation of a sexual harassment complaint is similarly unlawful and will not be tolerated.
Because the Rowe School Committee takes allegations of sexual harassment seriously, we will respond promptly to complaints of sexual harassment and where it is determined that such inappropriate conduct has occurred, we will act promptly to eliminate the conduct and impose such corrective action as is necessary, including disciplinary action where appropriate.
Please note that while this policy sets forth our goals of promoting a workplace and school environment that is free of sexual harassment, the policy is not designed or intended to limit our authority to discipline or take remedial action for workplace or school conduct which we deem unacceptable, regardless of whether that conduct satisfies the definition of sexual harassment.
Definition of Sexual Harassment: Unwelcome sexual advances; requests for sexual favors; or other verbal or physical conduct of a sexual nature may constitute sexual harassment where:
1.
Submission to such conduct is made either explicitly or implicitly a term or condition of a persons employment or educational development.
2.
Submission to or rejection of such conduct by an individual is used as the basis for employment or education decisions affecting such individual.
3.
Such conduct has the purpose or effect of unreasonably interfering with an individuals work or educational performance or creating an intimidating, hostile, or offensive working or educational environment.
The Grievance Officers: [Patricia Bell, Director of Pupil Personnel Services, and
Michael A. Buoniconti, Superintendent of Schools, 24 Ashfield Road, Shelburne
Falls, Massachusetts 01370, 413-625-0192]
The committee will annually appoint a sexual harassment grievance officer who will be vested with the authority and responsibility of processing all sexual harassment complaints in accordance with the procedure set out below:
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1.
Any member of the school community who believes that he or she has been subjected to sexual harassment will report the incident (s) to the grievance officer.
All complaints shall be investigated promptly and resolved as soon as possible.
2.
The grievance officer will attempt to resolve the problem in an informal manner through the following process: a.
The Grievance officer will confer with the charging party in order to obtain a clear understanding of that party's statement of the facts, and may interview any witnesses. b.
The grievance officer will then attempt to meet with the charged party in order to obtain his or her response to the complaint. c.
The Grievance officer will hold as many meetings with the parties as is necessary to facts. d.
On the basis of the Grievance officer's perception of the situation he or she may:
1.
Attempt to resolve the matter informally through reconciliation.
2.
Report the incident and transfer the record to the superintendent or his/her designee, and so notify the parties by certified mail.
3.
After reviewing the record made by the grievance officer, the superintendent or designee [Name. Office, Address, Phone Number] may attempt to gather any more evidence necessary to decide the case, and thereafter impose any sanctions deemed appropriate, including a recommendation to the committee for termination or expulsion. At this stage of the proceedings the parties may present witnesses and other evidence, and may also be represented. The parties, to the extent permissible by law, shall be informed of the disposition of the complaint.
All matters involving sexual harassment complaints will remain confidential to the extent possible. If it is determined that inappropriate conduct has occurred, we will act promptly to eliminate the offending conduct.
4.
The grievance officer, upon request, will provide the charging party with government agencies that handle sexual harassment matters.
Revised: November 20, 1996
Legal Ref.:
Title VII, Section 703, Civil Rights Act of 1964 as amended 45
Federal Regulation 74676 issued by EEO Commission
Education Amendments of 1972, 20 U.S.C. 1681 et seq. (Title IX)
Board of Education 603 CMR 26:00
First Reading: November 9, 2010
Second Reading and Adoption: December 14, 2010
Rowe School District Committee
18

Reporting
Any member of the school community, students, staff, parents, or other community members may make a complaint and report bullying or retaliation behavior orally or in writing. Bullying and Harassment Incident Complaint Reporting Forms
(Appendix A) can be found in a school’s main office, nurse’s office, and guidance office.
This form can also be found on the homepage of the District’s website at www.mohawkschools.org
The form can be used to report retaliation as well as bullying or harassment. Forms in other languages will be available as needed. A developmentally appropriate form written for elementary students is also available. (Appendix C) Forms should be returned to the school office.
Any school community member may make an anonymous report of bullying, harassment, or retaliation by downloading and printing an Anonymous Bullying Report
Form (Appendix B) available on the homepage of the district’s website and on the homepages of each school’s website. In addition, anonymous reporting forms are available at local public libraries. A standard Complaint and Reporting Form can be used as an anonymous form by omitting the name of the one filing the report. Anonymous information cannot be used by itself for disciplinary proceedings, but it may lead to an investigation into the allegation. Anonymous Bullying Report Form can be used to report retaliation as well as bullying or harassment.
Any member of the school community who retaliates against another for reporting bullying or harassment, or who knowingly makes a false accusation of bullying or harassment will be subject to disciplinary action. The Incident Report Form and the
Anonymous Report Form can also be used to report retaliation incidents. Incidents of retaliation will be treated very seriously and will be responded to promptly.
All individuals who are reported as aggressors, targets, witnesses, or are otherwise involved in a bullying incident will be afforded the same protection regardless of their legal status.
Investigation
Investigations are coordinated by the building Equity Officer (EO). At the middle and high school the vice principal is the Equity Officer and at the elementary level the principal is the EO. Investigations will be carried out by the EO or his designee.
There are circumstances in which an incident is referred to the District Equity
Officer or Superintendent of Schools.

When a parent, guardian, or student feels an incident was not resolved at the building level.

When an incident involves the Equity Officer or principal or other building staff responsible for an investigation.
19


When a situation remains unresolved after an investigation and corrective action. Usually this would be two or more substantiated incidents involving a single individual or group.

Adult to adult bullying behavior.
Investigations are documented using the Bullying and Harassment Incident
Report Tracking Form (Appendix C) and the RITA ( R eport, I nvestigate, T ake A ction)
Protocol Checklist (Appendix D). These forms will be used to help determine whether or not bullying, harassment or retaliation occurred and will document the type of violation.
The forms will document the corrective or disciplinary action taken and the notification of all relevant individuals. The RITA Protocol Checklist will serve as a reference throughout the process to ensure appropriate steps are taken and follow-through is completed. If allegations are substantiated, completed forms are sent to the District Data
Manager. The Data Manager will monitor whether the aggressor has been the subject of a previous complaint in another building.
Investigation of the complaint will be concluded within 14 school days of the filing of the initial report. Most investigations will be concluded within 10 school days.
If the complaint against the aggressor is substantiated the investigator’s report will:

Provide for reasonable, timely, and age-appropriate corrective action intended to stop the bullying or retaliation behavior and prevent its reoccurrence.

Document steps to address the effect of the bullying or retaliation behavior on the target.

Document steps to protect the target and/or one who filed the complaint from retaliation.

Provide corrective action for anyone who knowingly makes a false report of bullying.
 The Equity Officer will have an educational discussion with the aggressor and bystanders about the consequences of bullying behavior and the fact that everyone is now aware of the situation. Equity Officer will discuss the consequences if bullying behavior continues or if retaliation occurs.
In exceptional cases in which a formal investigation is not needed and immediate action is required, the Equity Officer may immediately inform targets, aggressors, and bystanders about the consequences of bullying or retaliation in school and immediately follow-through with consequences.
Notification
Following preliminary screening, parents/guardians of all students involved in an incident will be notified by an Equity Officer or his designee within one school day of the filing of a bullying, harassment, or retaliation report or complaint.
20

When criminal charges may be pursued against the aggressor, the local law enforcement agency must be notified by the Equity Officer.
When the incident involves students from more than one school or school district, the Equity Officer immediately notifies the principal of the other school so both schools can address the incident promptly.
The Equity Officer will notify the aggressor’s parents/guardians, in accordance with state and federal privacy laws, of disciplinary action taken. Parents will be informed about the seriousness of retaliation. Counseling or a referral to an outside agency will be offered to the aggressor’s family.
The Equity Officer will notify the target’s parents/guardians, in accordance with state and federal privacy laws, that action has been taken to stop the bullying behavior, and prevent both reoccurrence and retaliation. Parents will be informed about the seriousness of retaliation and advised to report any retaliation incidents. Counseling or a referral to an outside agency will be offered to the target’s family.
The Equity Officer will notify the individual who filed the complaint, in accordance with state and federal privacy laws, if he/she was not the target or parent/guardian, that his/her complaint has been investigated and action has been taken.
The individual will be informed about the seriousness of retaliation and advised to report any retaliation that occurs.
Safety Plans
Each school’s Equity Officer in consultation with his staff will develop a safety plan for targets of bullying or harassment. A safety plan may also be created for anyone who is the object of retaliation. An individual who reports, witnesses, or cooperates in an investigation and feels threatened or intimidated may have a safety plan. Students who provide information as part of an investigation, or students who are reliable witnesses, or who might be aware of bullying and provide relevant information, are all entitled to safety plans. All provisions for protection and for safety plans apply to all students who are in any way part of a bullying incident as target, aggressor, witness, bystander, or informant.
The Safety Plan will include:
 A Safe Zone or area where the target or others can go to get help from a trusted adult.

A protocol for informing all relevant adults (bus driver, counselor, playground monitor, etc.) of the situation that exists between the target/others and the aggressor.

A plan to monitor less structured areas of the school like hallways, cafeteria, bus, and playground.

Weekly assessment of the effectiveness of the Safety Plan.

A plan of action to be taken in the event of retaliation against the target or any other individual.
21

Requirements for Students with Disabilities
Students with disabilities may need additional support at school as they develop social skills. For students identified as being on the Autism spectrum or having a disability that affects social skills development, the IEP or 504 Team needs to evaluate that student’s vulnerability as a bully or a target. The IEP Team will need to specifically address the social skills needed to avoid becoming a bully or a target as well as how to respond if bullying occurs.
The IEP or 504 team can recommend pragmatic language and /or counseling services to supplement a school's social skills curriculum. The social skills curriculum may require reinforcement, repetition, or modification to reach a student with identified social skills deficits. This is often provided by small group instruction but may be provided through individualized instruction.
A guidance counselor, school adjustment counselor, or psychologist monitors a student’s social skills development and responds to socially challenging circumstances in the school environment. Concerns are reported to a student’s family promptly and diplomatically. If a student with an identified disability is involved in a bullying, harassment, or retaliation incident, either as a target or aggressor, there should be careful consideration of the student’s disability.
Staff Professional Development
Leadership Training
In Spring 2011, Administrators who serve as District Equity Officer and Equity
Officers in each school will receive leadership training about bullying prevention and intervention procedures and plan implementation. They will learn strategies for intervention to stop bullying and retaliation, information about the power differential between aggressor and target, identification of students at risk for bullying, as well as information about Internet safety and cyber-bullying. Middle School team of teachers and student leaders attended an all-day anti-bullying workshop at Westfield State
University in January 2011. An administrator will receive two days of facilitator training in Steps to Respect in April 2011.
Staff Training
In Spring through Fall 2011 the District school staff will have professional development about the Plan and its implementation. Staff will learn strategies for intervention to stop bullying and retaliation, information about the power differential between aggressor and target, identification of students at risk for bullying, as well as information about Internet Safety and cyber-bullying. Classroom teachers in grades K-6 will receive training in Second Step and Steps to Respect. Middle and High School teachers will receive training in Olweus. Olweus will be implemented in Middle and
High School in Fall 2011. At staff meetings in District schools there will be school-wide training in Responsive Classroom and social skills development, in the use of antibullying and social skills curriculum, as well as a review of reporting and investigation procedures. In addition to classroom teachers, this training will include specialists, paraprofessionals, and staff including coaches, bus drivers, and cafeteria workers. The
District leadership team will continue to look for opportunities for teachers to attend
22

workshops and conferences, like the anti-bullying conferences at Westfield State
University. Teachers may choose to attend anti-bullying and social skills training in
Summer Academy, a summer program for teachers sponsored jointly by Franklin and
Hampshire County school districts, and the Collaborative for Educational Services,
Northampton.
Training for Specialists
In Spring through Fall 2011 school nurses, psychologists, guidance and adjustment counselors, special educators, and paraprofessionals who work with socially vulnerable students will have training about bullying prevention and intervention strategies for students with disabilities. They will learn strategies for intervention to stop bullying and retaliation, information about the power differential that exists between aggressor and target, identification of students at risk for bullying, as well as information about Internet safety and cyber-bullying. They will identify at-risk students and ensure those students and their families receive additional support, as needed. Individuals may choose to attend Summer Academy to take courses in Social Thinking, Steps to Respect, and other anti-bullying programs.
Training in Use of Social Skills Curriculum
In Spring through Fall 2011 teachers will have training about how the Bullying
Prevention and Intervention Plan connects to adopted social skills and anti-bullying programs. They will connect what they learn about programs to strategies for intervention to stop bullying and retaliation, information about the power differential between bully and target, as well as information about Internet safety and cyber-bullying.
Annual Training
In subsequent years the District will notify all teachers annually about the Plan and procedures. There will be additional training for new teachers. Within the first two weeks of school, staff will receive annual written notice of the plan through published information about the plan. The plan will be posted on the District website and on all school websites. Printed copies of the plan will be available in the school offices of all
District schools and in the District’s Central Office. Teachers and staff will be notified about the provisions of the plan related to staff duties including the reporting procedure, power differential, at-risk students, and cyber-bullying. A colleague or administrator will provide an overview of the social skills curriculum. Parents will receive annual notification about the Plan, and reporting and investigation procedures. We will distribute a parent brochure annually at the beginning of each school year and to new students’ parents when a student is enrolled in the District.
Other Professional Development
There will be on-going professional development opportunities in the areas of social skills development and bullying and retaliation prevention and intervention. These opportunities may include films, book groups, lectures, and panel discussions.
Professional development events will address bullying and retaliation, power differential between bully and target, identification of at-risk students, and Internet safety.
Professional development events may be open to parents and interested community members.
23

Parent and Community Engagement
District and school level parent education programs will be held in Spring/Fall 2011 to explain the District Plan and procedures to parents/guardians and to advise parents how they can help reinforce the Plan at home. In subsequent years, once parents understand the Plan, it will be explained annually.
The District has developed a brochure about bullying for parents/guardians.
(Appendix F) We will distribute this brochure to all parents annually and to new parents when their child is enrolled in the District.
There will also be additional educational programs to explain District social skills curriculum and to engage in problem solving about parenting issues. Parents will learn about the bullying power differential and about online safety.
The Anti-Bullying Leadership Team will annually evaluate the effectiveness of the
District Plan and the effectiveness of District anti-bullying programs. They will make recommendations to the District Equity Officer.
The District will reach out to community organizations like Department of Children and Families, Kiwanis, United Arc, Clinical and Support Options, and religious organizations. Their advice and resources will support the District, its families, and students.
All Students
When the Bullying Prevention and Intervention Plan is adopted by the school committee and accepted by the Department of Elementary and Secondary Education, the District and its schools will begin the process of explaining policies and procedures contained in the Plan to all students.
While a Bullying Policy is contained in the District’s Student Handbook, and parents and students are familiar with the District Bullying Policy, the District will ensure that students understand, in a developmentally appropriate way, the procedures with regard to

Reporting an incident
 Understanding responsibility of a bystander, witness, or informant

Knowing where forms are available and how to ask for a form

Filing a complaint orally and in writing

Filing an anonymous bullying, harassment, or retaliation report

Understanding steps in an investigation

Understanding if allegations are substantiated, appropriate actions will result
 Knowing what to do if retaliation occurs

Knowing what a safety plan is and when to ask for one whether one is a target, bystander, witness, or informant.
The Bullying Prevention and Intervention Plan will be explained to students annually during the first two weeks of the school year.
24

Social Skills Curriculum
The District had previously adopted and implemented Second Step, published by the Committee for Children, as our social skills curriculum in grades K - 6. In 2010 the district purchased Steps to Respect, an evidence-based social skills curriculum with an anti-bullying focus, also published by the Committee for Children.
In Kindergarten through Grade 2, students will study Second Step. In Second Step students will learn pro-social values like empathy, anger management, and self control.
As part of social skills training, students will learn about alternatives to discipline like restorative justice, making amends, and community service.
In grades 3 - 6 students will study Steps to Respect, which includes both explicit antibullying instruction and ethical values lessons.
In grades 7 through 12, middle and high school faculty and staff have adopted
Olweus as their anti-bullying program. Olweus, started by Dr. Dan Olweus of the
University of Bergen, Norway, is the oldest, evidence-based bullying prevention program. Teachers will receive Olweus training in Spring through Fall 2011, with implementation to begin in Fall 2011. High school student leaders may enroll in
Hampshire County District Attorney’s office workshop, Cyber-Smart, to become trained mentors. High school students will then be equipped to mentor elementary students about the dangers of cyber-bullying. All students will be trained about cyber-bullying dangers and instructed to report cyber-bullying immediately to parents, teachers, administrators, staff, or other school personnel. Massachusetts Aggression Reduction
Center has an anti-bullying training program at Bridgewater State which is being considered by the middle and high school Equity Officer.
All students will be trained about the important role bystanders play in stopping bullying and retaliation and will be equipped to promptly step in when they see bullying or retaliation occur.
The District timeline for implementation of a social skills curriculum, is that in
2010 – 2011 Second Step and Steps to Respect will be taught. Concurrently, the middle and high school will implement Olweus and other programs appropriate for middle and high school students.
The District’s social skills curriculum will be evaluated annually for its effectiveness by students, teachers, and administrators.
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Students in Need of Additional Support
Counseling and Support Services
Students who need additional social-emotional support are currently receiving counseling and guidance from school psychologists, guidance counselors, and special educators. IEP and 504 Teams may explore implementing an evidence-based social skills curriculum and additional time in social skills groups for students who are especially vulnerable to bullying and harassment due to race, disability, or gender orientation. These programs will be implemented in 2011 – 2012.
Any programs for vulnerable students will be evaluated annually for effectiveness by students, teachers, and administrators.
In addition, some students and families may need to be referred to outside services. School psychologists, guidance counselors, and/or special educators will help students and families find the outside services they need in a timely way.
26

In September 2010 the District conducted its first surveys about bullying to create a baseline for instruction and to enhance school climate and culture. The following surveys were posted online at https://www.surveymonkey.com.
Survey
Students Grades 3-6
Source of Survey
Southern Poverty
Law Center
Number of
Respondents
277
Percent Who
Participated
74%
Middle and High
School
Young Adult Lit.
Teacher Resources 368 64%
Teachers, Admin., and Staff
Parents/Guardians
Connecticut
Dept. of Education
Province of Alberta
Canada
239 74%
57% 447
Surveys were posted from Sept. 10, 2010 through Oct. 9, 2010. More than 50% of each group responded to the surveys.
Complete survey results are included in Appendix E. Here are highlights of data the
District gathered to plan for the future.
Bullying Survey Grades 3 – 6
Students in the District’s six elementary schools, who are between 8 and 12 years old, generally reported an absence of bullying behavior. For the most part when behavior seemed like bullying it was usually “just kidding” or “we were just joking around.”

28% of students responding reported they had been called names

23% of respondents had been hit, kicked, or pushed.

40% of students who responded reported these incidents while 60% did not tell anyone.

28% of students responding reported seeing someone else bullied.

10% of respondents admitted they had bullied others.
Elementary students may have said what they thought adults wanted to hear, that is, bullying is not a problem. The open response format of this survey may not have been an effective format for elementary students. Next year when the District surveys elementary students, we may want to use focus groups or some other method of gathering data.
27

Middle and High School Bullying Survey
70% of middle and high school students who responded report they had not been bullied at school. 30% of middle and high school respondents admitted they had bullied others.
Among middle and high school students as among elementary students, name calling was the most prevalent form of bullying. 36% of respondents reported they had been called names and 28% admitted they had called others names.
20% of respondents reported being kicked, hit, or tripped. 19% of students responding said they had been ignored or excluded.
When bullying occurred, only 17% of middle and high school students told anyone about the incident. 20% just ignored the incident and 11% avoided the bully.
60% of middle and high school students surveyed thought teachers and staff were aware of bullying incidents. 25% of students surveyed thought school rules about conduct and behavior were always enforced, while 37% said rules were sometimes enforced. school.
23% of respondents said they had participated in an anti-bullying program at
Middle and high school respondents identified certain “hot spots” for bullying:
Bullying “Hot Spots” in
Middle and High School
Hallways
Locker Rooms
Percent of Respondents that Identified
“Hot Spot”
76%
44%
Cafeteria 41%
Lockers 38%
Note: Consistent with practices in other school systems, the District has recently installed security cameras in several corridors of the middle/high school building. These cameras provide for increased oversight of the public hallways; a significant reduction in student traffic during classes has already been noted.
Parent Survey About Bullying
Of the parents who responded to the Parent survey, 60% reported their child always felt safe at school. 87% of parents surveyed thought their child’s school did an average, above average or excellent job of making school a safe place.
36% of respondents said their child had been bullied at school. According to parents surveyed, when bullying occurs it is most likely to happen in classrooms (31%), hallways (30%), and on the playground (40%). Respondents also identified school buses and cafeterias as places bullying occurs. About 10% of parents surveyed said their child had stayed home from school to avoid being bullied.
28% of respondents reported that if their child were bullied at school, school personnel would never report the incident. 35% of parents surveyed said rules of conduct were enforced often, while 30% said rules were enforced sometimes. 42% of parents surveyed weren’t sure what would happen if a student told an adult about bullying, implying they did not know or were uncertain if adults would act on a report.
38% of respondents reported they had never been invited to participate in an antibullying program at their child’s school. 36% had sometimes been invited to participate.
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The parent survey had a box for parents to give additional information. 149 parents wrote anecdotes and comments about their child’s school experiences with bullying.
Bullying and School Climate Survey – Teachers, Administrators, and Staff
Teachers and staff surveyed said the following interventions were frequently used with aggressors:

87% had a conference with bully

81% increased supervision

75% issued a warning

74% engaged aggressor in counseling

73% used peer mediation
33% of teachers and staff surveyed said a list of verified bullying incidents is immediately available for public inspection if parents ask. 78% of respondents said their school does not have a list of verified acts of bullying incidents.
96% of respondents said that student handbooks are the method used to disseminate the District’s Bullying Policy and that notification about the Bullying Policy is given annually.
Teachers and staff surveyed believe parents of targets and aggressors should be notified and 85% report parents/guardians are notified within 24 hours of an incident.
What We Learned from Survey Process
This was the first time the District had conducted surveys online. We did not know how respondents would react to the online format.
What we found was online surveys worked well, especially for families. The
Superintendent of Schools emailed families to tell them about the surveys and to send them a link. The Superintendent also called families using an automated call system. We sent out one follow-up email to families. Families responded well to the online survey and appreciated the confidentiality it offered. They knew that their honest responses, comments, and anecdotes would be anonymous.
Online surveys worked well for middle and high school students and teachers, administrators and staff. For middle and high school students the surveys were taken in computer labs at school. Teachers and staff had a link to their survey and could take it at home or school. Participation was good but we emailed repeated reminders for middle and high school students, teachers, and staff.
The online survey for elementary students was successful in that 74% of students in grades 3 through 6 took the survey at school. The open response format was not the best format for elementary students and did not yield as much useful information. Some students may not have understood the questions and other students may have been concerned with pleasing adults. In the future we want to explore other formats for elementary students, like pre and post-assessments in Second Step and Steps to Respect and focus groups with an adult moderator.
29

Future Bullying Surveys
The District plans to survey students, parents, teachers and staff annually, which we began in September 2010.
In future years as part of our annual process we will survey in spring, revise in summer, and post the Plan for comment in late summer/early fall. The purpose of climate and bullying surveys is to
 enhance District and school climate
 evaluate the effectiveness of District social skills curriculum
 target parent education programs
 provide meaningful professional development for teachers and staff
The school and District climate surveys will also be used to help staff assess other climate issues that are related to bullying and harassment, like enforcement of rules of conduct.
30

Appendix A. Bullying, Harassment and Retaliation Incident Complaint Reporting Form
Appendix B. Anonymous Bullying Report Form
Appendix C. Elementary Bullying Report Form
Appendix D. Bullying, Harassment and Retaliation Incident Report Tracking Form
Appendix E. RITA Protocol Checklist for Bullying, Harassment and Retaliation
Appendix F. Parent Brochure
31

Appendix A
BULLYING, HARASSMENT AND RETALIATION INCIDENT COMPLAINT REPORTING FORM
______________________ School District – __________________ School
1.
Name of Reporter/Complainant : __________________________________________________________________
2.
Check whether you are the:
Target (of behavior)
3.
Check whether you are a:
Reporter (not the target of the behavior)
Student Staff member Other (specify) _______________________________
Parent Administrator
3A.
Provide your Contact Information/Telephone# : ___________________________________________________
4.
If student, state your School : ______________________________________ Grade : _______ Homeroom : _______
5.
If staff member, state your School or Work Site : ______________________________________________________
6.
Information about the incident:
Name of target (of behavior): ______________________________________________ student staff other
Name of subject of report/complaint : ______________________________________ student staff other
Date ( s ) of incident(s): ___________________________________________________________________________
Time(s) when incident(s) occurred: _________________________________________________________________
Incident location(s) (be as specific as possible) : ___________________________________________________________
7.
Witnesses
(list people who saw the incident OR have relevant information about the incident)
:
Name: ________________________________________ student staff other (specify) __________________
Name: ________________________________________ student staff other (specify)
__________________
8.
Describe the details of the incident (names of persons involved, what occurred, and what each person did and said, including specific words used; use additional paper if necessary) :
9.
Have you taken any action on this matter?
Yes ________ No_________ (if “yes” please describe action taken and when; use additional paper if necessary)
10.
Signature of Reporter/Complainant : _________________________________________ Date: ________________
11.
Form provided to: ________________________________ Position: _________________ Date: ________________
Signature: ______________________________________________________________ Date: ________________
PLEASE SEND COMPLETED FORM TO _________________________________________________.
32

Office of Curriculum and Assessment
24 Ashfield Road, Shelburne Falls, MA 01370
Date:
Submitted By: (optional)
School:
Name of Bully:
Grade of Bully:
Date of Incident:
Details of Incident:
Location of Incident:
Time of Incident:
Number of Witnesses:
Who has been told:
Number of times this has happened:
It is the responsibility of the school to investigate the accuracy of every Bully Report and then take the steps necessary to stop any further harassment. The Mohawk Trail Regional School System agrees to treat reports in a professional manner and respect the person who submitted it in their desire to remain safe and anonymous. This report is considered confidential whether you choose to remain anonymous or not. School staff will show it only to the persons who are directly involved in this incident.
31

Appendix C
Elementary
Name: _________________________________________________________________
Date: __________________________________________________________________
WHO was involved?
Target _________________________________________________________________
Bully __________________________________________________________________
WHEN Date ____________________ Time: _______________________________
WHERE _______________________________________________________________
WHAT happened? _____________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
WHO saw what happened? _____________________________________________
________________________________________________________________________
________________________________________________________________________
WHO did you tell? ______________________________________________________
________________________________________________________________________
________________________________________________________________________
WHAT did you do? _____________________________________________________
________________________________________________________________________
________________________________________________________________________
32

Appendix D
BULLYING, HARASSMENT AND RETALIATION INCIDENT REPORT TRACKING FORM
______________________School District – School Name _____________________
TO BE COMPLETED BY ADMINISTRATORS OR THEIR DESIGNATED OFFICIAL(S)
1.
Incident:
School/Building: _____________________ Name of Incident Reporter(s): ______________
2.
Name
(If not student indicate if staff member/other)
3.
Date(s): _____________________
Time(s): _____________________ Date of Report/Complaint: _________________
Location(s): _____________________
Target of behavior:
ID # Age Grade
Subjects(s) of the complaint/report:
Name
(If not student indicate if staff member/other)
ID # Age Grade
Student Employee Other _________
Sex Race/
Ethnicity
Sex Race/
Ethnicity
Repeat
Target
(Y/N)
Repeat
Target
(Y/N)
Target new to district
(Y/N)
Target new to district
(Y/N)
SPED/ELL student
SPED/ELL student
Parent
Notified
(Y/N)
Parent
Notified
(Y/N)
Race/Ethnicity
Code Key
Use all that apply.
A - Asian or Asian
American
AI/AN – American
Indian or Alaskan
Native
B – Black or
African American
PI – Pacific
Islander or Native
Hawaiian
W – White/
Caucasian
H – Hispanic,
Latino, Chicano
ME – Middle
Eastern
BR – Brazilian
O - Other
4.
Witnesses: (List people who saw the incident OR have pertinent information)
1) Name: __________________________ Student Staff Member Other ________________________
Contact information/phone # ___________________________________________________________________
2) Name: __________________________ Student Staff Member Other ________________________
Contact information/phone # ___________________________________________________________________
3) Name: __________________________ Student Staff Member Other ________________________
Contact information/phone # ___________________________________________________________________
5.
Summarize the details of the incident (Be as specific as possible, including who was involved, what each person did and said, specifying the words used . Use additional paper if necessary.)
:
6.
Action(s) taken by staff member(s) at time of incident:
7.
Referred to the following designated official/administrator : _______________________________________
8.
Initial parent/guardian notification :
Date__________time__________parent/guardian name ____________________________________________
9.
District Equity officer notified: Yes No
10.
Police notified: Yes No Police Responded: Yes No Responding Officer: ___________
Nature of police involvement (circle all that apply):
Took person into custody Responded to school/bullying Intervened during incident
Other
11.
Bias Indicators related to incident (circle any that apply):
Aggressor and target are from different groups
Derogatory words/writings/gestures used relating to target’s group
Target belongs to a group that is relatively small in number in school
Aggressor had prior incidents with members of target’s group
Incident occurred on a holiday or date significant to target’s group
Target perceives that incident was motivated by his/her group membership
Definition: “Group”
An individual’s membership/classification based on race, color, ethnicity, national origin, religion, sex, sexual orientation, gender identity, or disability.
Target participates in an activity/club promoting his/her group
33

12.
Is behavior or incident potentially motivated by the target’s
(circle any that apply):
Race/Color Ethnicity/National Origin Sex (gender) Disability/SPED (actual or perceived)
Religion Gender identity (actual or perceived)
13.
Injury to incident participants: Yes No
13A. Caused serious bodily injury to another:
14.
Resolution process used
Age Sexual Orientation (actual or perceived)
If yes, state who was injured and describe injuries:
Yes No
Formal Informal Disciplinary code Other _______________________________________________
15.
Report/complaint investigated by: ____________________________________________________________
16.
Report/complaint sustained: Yes No
17.
Determination made by: ____________________________________________________________________
18.
Type of Incident (circle all that apply):
PERSONAL PROPERTY
Threats/intimidation
Sexual harassment
Harassment (except sexual)
Discrimination
Bullying
Cyber-Bullying/Harrassment
Fight
Physical attack, assault
No weapon used
Weapon(s) used
--- Identify weapon(s) used: _________________
Graffiti
Property damage
Vandalism/destruction of property
Arson
Theft
Robbery
Derogatory words/gestures Retaliation Retaliation
Other: ______________________
19.
Type of civil rights/anti-bullying policy violation found (circle all that apply):
Other: _____________________________
Student to student Staff to student Student to staff Staff to staff Other ______________________________
Race/color
Religion
National origin/Ethnicity
Sex (gender)
Disability
Sexual orientation
Retaliation
Bullying
Age None/not applicable
20.
Disciplinary and corrective action taken (include programs or alternative actions employed):
20A.
In-school suspension: Exclusion or expulsion:
Out-of-school suspension:
21.
Additional comments:
Removed to alternative setting (for SPED students):
22.
Additional parent/guardian contact(with dates and times):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________________________________________________
23.
Other agency reports filed?
Yes No Agency: _______________________________________________________________________________
Report Title: ______________________________________ Number/Name: _______________________________________
24.
Designated official name: _________________________________
25.
Designated official signature: _____________________________________ Date : ________________
26.
Report forwarded to district equity coordinator?
Yes
District equity coordinator signature: ________________________________
Date : ________________
Date : ________________
34

Alleged Target’s Name: _____________________________ EO’s Name: _____________________
Important Note: The Building Equity Officer (EO) is responsible for maintaining this checklist, even if s/he does not complete each step her/himself. When completed, send copy to District Equity Officer.
Check
(√)
Procedural Step Date &
Initials of
“Checker”
Comment/Reminder
NO /
YES
A. Reporting
Incident Complaint Form (ICF) and/or existing office referral form received.
ICF reviewed by building Equity
Officer (EO).
Copy of ICF sent to District Equity
Officer (DEO).
EO informs alleged aggressor(s) about complaint.
EO informs alleged aggressor(s) about retaliation.
EO informs alleged target that alleged aggressor(s) has/have been told about complaint & warned about retaliation.
Building administrator or EO informs parents/guardians (P/G) of both alleged target(s) & alleged aggressor(s) about complaint & investigation, if one is required.
B. Investigating
Incident is referred to District EO for investigation (If YES, skip this section).
Incident Report Tracking Form is initiated to document investigation.
Interviews are completed.
Physical evidence is reviewed.
P/G of
Target(s):
P/G of
Aggressor(s):
Submitted by:
Received by:
If more than one, add’l info here:
Names?
If YES, give reason:
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Check
(√)
Procedural Step Date &
Initials of
“Checker”
Comment/Reminder
Investigation is completed within 5 days.
If not completed within 5 days, EO informs all parties (including parents/guardians) of first 5-day extension
EO informs DEO of first extension.
If not completed within 5-day extension, EO informs all parties
(including parents/guardians) of second 5-day extension
EO informs DEO of second extension.
EO determines incident is bullying.
EO determines incident is harassment.
EO completes Incident Report
Tracking Form (plus brief written report, if needed).
C. Taking Action:
Consequences & Notification
EO and/or Principal determine(s) consequences, if any.
If consequences are given, EO informs
DEO
EO informs aggressor(s) & parents/guardians of results and consequences, if any.
EO informs target(s) & parents/guardians of investigation’s results (but NOT of consequences).
EO will inform staff member(s) interviewed about complaint’s results.
Copies of this checklist, tracking form, and any written reports are forwarded to DEO.
NOTES: If DEO does not receive notification of extension(s) and/or results/consequences within the time periods defined by the Bullying/Harassment Policy, then the DEO is responsible for contacting the Building EO and/or Principal to find out where and why the process has stalled.
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Appendix F
Parent Brochure
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Appendix F
Parent Brochure
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Thanks to the presenters of the workshops listed below. Their ideas, suggestions, and documents have been invaluable to us in writing this plan.
Responding Effectively at the School and District Level to the MA Anti-Bullying Law
Presented on Oct. 4, 2010
Collaborative for Educational Services, Northampton, MA
Ms. Randy Ross, Equity and Diversity Specialist
New England Equity Assistance Center
Brown University, Providence RI
Bullying and Cyber-bullying: School District’s Obligation
Presented on Oct. 6, 2010
Collaborative for Educational Services, Northampton, MA
Ms. Regina Tate, Esq.
Murphy, Hesse, Toomey and Lehane, LLP
Quincy, MA
Thanks also go to consultant, Barbara Coloroso , Littleton, CO, who spoke by phone with us regarding bullying surveys.
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