William Adams PBIS Discipline Referral Flow Chart Is the Offense Level 1, Level 2, or Level 3? Level 1 Level 2 An offense that does not significantly disrupt the learning environment. Examples include, but are not limited to: • Excessive talking • Conversational profanity • Food or drink in the classroom • PDA (hugging) • Not complying with c lassroom expectations, procedures, or routines set by the teacher • Repetitive noises or disruptions/actions that disrupt the classroom • Not staying in seat/assigned area • Mild horseplay • Throwing objects, non-‐threatening • Repeated (and documented) Level 1 offenses. An offense that significantly disrupts the learning environment. Examples include, but are not limited to: • • • • • Use of cell phone or other electronic devices • • 2 Questions and a S tatement • • • Teacher fills out Discipline Referral Form and turns it into the Discipline office, along with copy of the Level 1 Infractions Documentation Form. (The student remains in the classroom until s/he is called) What are you doing? What should you be doing? Show me. Has the Level 1 offense occurred 3 or more times within the last 3 consecutive weeks? Classroom Intervention (Teacher documents incidents on *Level 1 Infractions Form) **Documented chronic Level 1 misbehaviors Throwing objects with intent to hit someone Conflict between students with potential for conflict PDA (kissing) Persistent refusal to c omply or respond to adult instructions (3 or more times, longer than 10 minutes) Disrespect to teacher, including significant oppositional behavior, profanity Negative remarks related to race, sexual orientation, culture Yes No Discipline Referral Teacher fills out discipline referral. Teacher contacts Discipline Center to request security pick up. If security officer not available, teacher notifies DC that student is on his/her way. Teacher makes parent contact the day of the incident and fills out all appropriate documentation. Level 3 An offense that significantly disrupts the learning environment and possibly jeopardizes the safety of self and/or others. Examples include, but are not limited to: • • • • • Major aggressive behavior Alcohol/Drug/Tobacco Possession (electronic cigarettes are included) Skipping class Fighting Damaging school property/vandalism Possession of pornography/Profane materials Sexual offense toward another student or staff • Possession of weapons/dangerous instruments • • -‐Remain Calm. -‐Follow Campus Crisis Management Plan. -‐Notify office immediately. Request security escort. ***Discipline Referral Form sent to DC as soon as possible*** *Level 1 Infractions Forms are available at the DC office. Forms must be completely filled out, and must contain all required information. Visit: www.pbisworld.org for intervention strategies and additional PBIS resources. **In order for a Level 1 Infraction to fall under a Level 2 category, the Level 1 Infractions Forms must show evidence that the Level 1-‐3 week timeline has been met, that teacher interventions have been followed and properly documented, and that the parents have been contacted each time.