Get Staff Victim Notification Request Form - California Department Of ...

Filling out the Staff Victim Notification Request Form is an important process for any staff member who has been a victim of an offender. This guide will assist you in completing the form online correctly and efficiently, ensuring that you provide all necessary information for a prompt response.

Follow the steps to complete the Staff Victim Notification Request Form smoothly.

1. Press the ‘Get Form’ button to access the Staff Victim Notification Request Form and open it in the online editor.
2. Enter the date of the incident in the corresponding field to ensure the timeline of events is clearly documented.
3. Provide the name of the staff victim in the 'Staff Name' field. This should include the full legal name as recognized by your employer.
4. Indicate your classification and work location. This helps to identify the administrative context related to the form.
5. Fill in the 'Description of Incident' section with a detailed account of the event. This should include relevant specifics that may assist in understanding the context of the situation.
6. Complete the 'Offender Information' section with the required details about the offender, ensuring to include their Youth/Parolee name, M number, facility or parole office, current location, and any applicable dates.
7. Check all applicable boxes related to the incident under the 'Please check all that apply to this incident' section to provide a comprehensive overview of the legal status.
8. In the 'Information Received by' section, print the name of the person completing the form along with their classification and facility or parole office.
9. Ensure the Superintendent/SPA/Designee review section is signed and dated by the appropriate authority to verify the submission.
10. Once the form is fully completed, use the options available to save changes, download, print, or share the form as needed.

Take action now by completing the Staff Victim Notification Request Form online.