Paraprofessional Duty Log Form
Building (Bowditch/Peabody Staff choose both buildings)
*
Atlantic
Bowditch
Forten Hall
Marsh
Peabody
Winter Break Duty
Date of Duty
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Staff Member on Duty
*
First Name (Chosen Name)
Last Name
Name of Second Staff Member on Duty (Leave blank on Weekend Daytime, Break or Summer SHA Duty)
First Name (Chosen Name)
Last Name
Who is the Professional Staff on Call?
*
Greg Howard
Chris Lannan
Briannah Wheeler
Dale Gerundo
Sebastian Kochall
Calia Monteiro
Nokomis Bramantecohen
Hannah Patrignani
Victoria Letsche
Olayinka Okano
How many rounds were completed for this evening's duty?
*
Two (Minimum expected amount of rounds for joint Bowditch/Peabody duty)
Three (Standard expected rounds per night for Central Campus Buildings)
4+ (If necessary depending on need)
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Round One
Time of Round One
*
Hour Minutes
AM
PM
AM/PM Option
Please provide details of any trends or observations made during this round:
*
Were there any IRs submitted for this round
*
No
Yes - Please enter the IR Number(s)
Please describe a brief description of the incident(s):
*
If multiple incidents on this round please separate by two paragraph spaces
Were any warnings given?
*
No
Yes
Please give the time, location, and nature of the warning:
*
Did you encounter any damage or facilities concerns?
*
No
Yes
Was a work order(s) submitted yet?
*
No (Please submit the work order as soon as possible)
Yes - Please enter work order number(s)
Please describe the nature and the location of the damage that was encountered:
*
Add any photos of Damage from this round
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Please use the duty phone to take phones and email them to yourself to upload them
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Round Two
Time of Round Two
*
Hour Minutes
AM
PM
AM/PM Option
Please provide details of any trends or observations made during this round:
*
Were there any IRs submitted for this round?
*
No
Yes - Please enter the IR Number(s)
Please describe a brief description of the incident(s):
*
If multiple incidents on this round please separate by two paragraph spaces
Were any warnings given?
*
No
Yes
Please give the time, location, and nature of the warning:
*
Did you encounter any damage or facilities concerns?
*
No
Yes
Was a work order(s) submitted yet?
*
No (If no, please submit work order as soon as possible)
Yes - Please enter work order number(s)
Please describe the nature and the location of the damage that was encountered:
*
Add any photos of Damage from this round
Upload Files
Drag and drop files here
Choose a file
Please use the duty phone to take phones and email them to yourself to upload them
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Round Three
Time of Round Three
*
Hour Minutes
AM
PM
AM/PM Option
Please provide details of any trends or observations made during this round:
*
Were there any IRs submitted for this round?
*
No
Yes - Please enter the IR Number(s)
Please describe a brief description of the incident(s):
*
If multiple incidents on this round please separate by two paragraph spaces
Were any warnings given?
*
No
Yes
Please give the time, location, and nature of the warning:
*
Did you encounter any damage or facilities concerns?
*
No
Yes
Was a work order(s) submitted yes?
*
No (If no, please submit work order as soon as possible)
Yes - Please enter work order number(s)
Please describe the nature and the location of the damage that was encountered:
*
Add any photos of Damage from this round
Upload Files
Drag and drop files here
Choose a file
Please use the duty phone to take phones and email them to yourself to upload them
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Round Four+
Include round 4 and any more rounds completed in this section
Time of Round Four
*
Hour Minutes
AM
PM
AM/PM Option
Please provide details of any trends or observations made during this round:
*
Were there any IRs submitted for this round?
*
No
Yes - Please enter the IR Number(s)
Please describe a brief description of the incident(s):
*
If multiple incidents on this round please separate by two paragraph spaces
Were any warnings given?
*
No
Yes
Please give the time, location, and nature of the warning:
*
Did you encounter any damage or facilities concerns?
*
No
Yes
Was a work order(s) submitted yet?
*
No (If no, please submit as soon as possible)
Yes - Please enter work order number(s)
Please describe the nature and the location of the damage that was encountered:
*
Add any photos of Damage from this round
Upload Files
Drag and drop files here
Choose a file
Please use the duty phone to take phones and email them to yourself to upload them
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Miscellaneous
Were there any lockouts?
*
No
Yes
Please write the Student's Name(s), room number, and time of the lock out(s):
*
If multiple lockouts on this please separate by two paragraph spaces
Does the Condom Dispenser and/or Sanitary Napkin Dispenser need refilling? (Less than 1/4 full)
*
No
Yes (if yes please upload picture)
Please upload a picture of the Sanitary Napkin and Condom Dispenser in one photo:
*
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