Workplace Violence Incident Log

Each Department is responsible for maintaining a Workplace Violence Incident Log. Departments may maintain separate logs for each worksite, or one Departmental log that identifies the worksite for each incident. The log shall not include any personal identifying information and shall be available to all employees and their representatives upon request.

The log must include the following for each reported or known incident:

• Date, time and location of the incident
• Workplace violence type (1, 2, 3, or 4)
• Detailed description of the incident
• A classification of who committed the violence:
  • client or customer
  • family or friend of a client or customer
  • stranger with criminal intent
  • current or former coworker, supervisor or manager
  • partner or spouse
  • parent or relative
  • or other perpetrator
• A classification of circumstances at the time of the incident, including but not limited to:
  • whether the employee was completing usual job duties
  • working in poorly lit areas
  • rushed
  • working during a low staffing level
  • isolated or alone
  • unable to get help or assistance
  • working in a community setting
  • working in an unfamiliar or new location
• A classification of where the incident occurred, such as:
  • In the workplace (e.g., office, shop, warehouse, etc.)
  • Parking lot
  • Other area outside the workplace
• Type of incident, including, but not limited to, whether it involved any of the following:
  • Physical attack without a weapon, including but not limited to, biting, choking, grabbing, hair pulling, kicking, punching, slapping, pushing, pulling, scratching, or spitting
  • Attack with a weapon or object, including but not limited to firearm, knife, or other object on self or others
  • Threat of physical force or threat of the use of a weapon or other object on self or others
  • Sexual assault or threat, including, but not limited to, rape, attempted rape, physical display, or unwanted verbal or physical sexual contact
  • Animal attack
  • Stalking
• Consequences of the incident, including, but not limited to:
  • Whether security or law enforcement was contacted and their response
  • Actions taken to protect employees from a continuing threat or from any other hazards identified as a result of the incident
• Information about the person completing the log, including their name, job title, and date completed 

DPS will maintain a County-wide incident log. Departmental staff must use the online Update Workplace Violence Incident Log Form to promptly notify DPS of incidents and investigations. Only authorized personnel will have access to this form.​