Background and Instructions

This Campus Security Authority Incident Report form is intended as a guide to assist a Campus Security Authority (CSA) in gathering information for reporting, in compliance with California Education Code Sections 67380-67383 and the Clery Act.

If you are concerned for the safety of any of the involved parties or other members of the community, CALL 805-437-8444 IMMEDIATELY!

The Clery Act requires reporting of crimes without unnecessary delay. It is critical in incidents involving a violent crime, sexual assault, or hate crime (or attempts of these crimes) that the CSA ask victims if they wish to report the incident directly to the police for investigation. If so, the CSA must report the crime immediately or as soon as practicably possible, per the California Education Code. Call the VCCCD Police Department at 805-437-8444 and ask for an officer to contact you. In all cases, the VCCCD Police Department will assist, even if the crime occurred off campus. Neither the California Education Code nor the Clery Act require CSAs to report the names of victims or suspects.

NOTE: The CSA must also contact a Title IX Coordinator if the incident being reported is a sexual assault or any incident that involves prohibited sexual conduct.

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Reportable Crime Offenses

Hate Crimes

The VCCCD is also required to report statistics for hate (bias) related crimes by the type of bias as defined below for the following classifications: murder/non-negligent manslaughter, negligent manslaughter, sex offenses (forcible and non-forcible), robbery, aggravated assault, burglary, motor vehicle theft, arson (see definitions above) and larceny, vandalism, intimidation, and simple assault (see definitions below).

A hate or bias related crime is not a separate, distinct crime, but is the commission of a criminal offense which was motivated by the offender's bias. For example, if a subject assaults a victim, it is a crime. If the facts of the case indicate that the offender was motivated to commit the offense because of his bias against the victim's race, sexual orientation, etc., the assault is then also classified as a hate crime.

VAWA Offenses

Arrests and Referrals for Disciplinary Action

CSA Information

As a CSA, it is your responsibility to gather and report basic information. Please complete all fields of this form to the best of your ability and with as much detail as possible. A CSA may not choose to be anonymous when making a report. 


Crime Details

When providing the location of the crime, please provide the building name, parking lot name/number, street name or cross streets, or nearby buildings. Please be specific as to where the indident is reported to have occurred (e.g., inside a classroom, office on campus, in a common area inside a building, outside a building, etc.).
(Check only if you selected on of the Hate Crimes above. Check all that apply.):

Questions

Please respond to the following two questions.


Consent to Include Personal Identifying Information


Incident Summary

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