Saltwater Coast Lifestyle Centre Incident and Breach Report Version 2

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Incident and Breach Information

• Details of Persons involved

  Yes

  No

  N/A

• Details of Witnesses<br>

  Yes

  No

  N/A

Types of Incident or Breach

Category One (Verbal Warning)

• Accidental Abuse

  Yes

  No

  N/A

• Accidental Language

  Yes

  No

  N/A

• Accidental Conduct

  Yes

  No

  N/A

• Dress Code (Minor)

  Yes

  No

  N/A

• Breach of Owners Corporation Rule (Minor)

  Yes

  No

  N/A

• Misconduct

  Yes

  No

  N/A

• Complaint (Minor)

  Yes

  No

  N/A

• Accident

  Yes

  No

  N/A

Category Two (8,12 and 26 Week Fob De-Activation, Access and Usage Withdrawn)

• Offensive Abuse

  Yes

  No

  N/A

• Offensive Lanuage

  Yes

  No

  N/A

• Offensive Conduct

  Yes

  No

  N/A

• Dress Code (Major)

  Yes

  No

  N/A

• Breach of Owners Corporation Rules (Major)

  Yes

  No

  N/A

• Refusal to Follow Instruction / Direction

  Yes

  No

  N/A

• Complaint (Major)

  Yes

  No

  N/A

• Intentional Act

  Yes

  No

  N/A

• Disturbance

  Yes

  No

  N/A

Category Three (12 Month Fob De-Activation, Access and Usage Withdrawn)

• Theft - Local Police

  Yes

  No

  N/A

• Assault - Local Police

  Yes

  No

  N/A

• Any Other Matters Involving Police

  Yes

  No

  N/A

Statement of Accounts

• A statement must be written narrative, presented in a logical sequence. Tell the story as it unfolded with as much details as possible.

• Record of all events and conversations that took place. Include a list of any supporting material that may clear people of any wrong doing.

• Add signature

  Sign

• Select date

  Date