Behaviour & Regulation Record Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Pupil Name *Member of Staff Reporting *ClassPLEASE SELECTNursery (Delphinus)Reception (Pegasus)Year 1 (Cygnus)Year 1 (Phoenix)Year 2 (Dorado)LynxDate / TimeDateTimeLocationClassroomPlaygroundHallCorridorIntervention SpaceToiletsOffsiteOtherPlease state where (if you chose other) *Staff Involved *What Happened?Briefly describe what was seen or heard using factual, observable language only.What happened *Possible Triggers or ContextPossible triggers: *Transition/changePeer conflictDemand/task difficultySensory/environmentUnstructured timeAnxiety/worryTiredness/hungerChange to routineUnknownOther Response Early? Additional Other: *Emotional intensity scale *HighMediumLowAdditional Context (if needed)Adult ResponseStrategies usedStrategies Used *Acknowledged feeling/stateReduced language demandsOffered regulation supportRepeated clear boundaryProvided processing timeChanged environmentSupported safe spaceRestorative conversationRequested additional supportApplied agreed follow-upWas Colleague Support Requested Early?YesNoNot NeededWhat appeared to help most? *OutcomeOutcome *Returned to learning with supportLeft class temporarilyParent informedInjury occurredFollow-up requiredCPOMS completedSLT involvedSent homeOutcome / Impact *Final Staff ReminderPlease ensure safeguarding concerns are recorded on CPOMS where appropriate. Record observable facts rather than assumptions or interpretations.Submit
