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ILLINOIS DEPARTMENT OF JUVENILE JUSTICE
Incident Report
If this anser is yes to any of the following quesitons, explain in narrative below:
Youth Center/Program
Select
IYC Chicago
IYC Harrisburg
IYC Pere Marquette
IYC St.Charles
IYC Warrenville
Date of Incident:
Time of Incident:
Was a Weapon Involved:
Yes
No
Was Property Damaged:
Yes
No
Were Arrests Made:
Yes
No
Were there Media Inquiries:
Yes
No
Were Restraints / Force Used:
Yes
No
Was Oleoresin Capsicum (OC) Used:
Yes
No
Appr. Unit and/or Law Enf. Agency Notified:
Yes
No
Any Injuries / Hospitalizations:
Yes
No
Youth / Staff Involved:
Name
I.D #
Name
I.D #
Witnesses to Incident:
Name
I.D #
Name
I.D #
Statement of Facts: (NARRATIVE)
