PREVENCION, DETECCION Y SEGUIMIENTO DE CASOS DE VIOLENCIA ESCOLAR

NOMBRE DE LAS PERSONAS AREDIDAS GRADO/CARGO

PERSONAS QUE ORIGINAN LA AGRESION GRADO/CARGO

DESCRIPCION DE LA SITUACION DE LA AGRESION

TRATAMIENTO DEL CASO

1. FUE REPORTADA POR EL COORDINADOS DE CONVIVENCIA la situación de conflicto al docente involucrado si
es de una asignatura determinada o al director de grupo si es un estudiante:
SI ___________ NO _________ PORQUE ____________________________________

2. SE SOLICITO al docente o director de grupo, hablar, explicar y conciliar la situación con las personas
involucradas
SI ___________ NO _________ PORQUE ____________________________________

3. Se realizo el dialogo, explicación y conciliación de la situación con las personas involucradas.

SI __________ Fecha: _____________
Conclusiones de la conciliación:
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NO __________ Porque no se realizo:
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4. PERSONA QUE REPORTA LA AGRESIÓN: ________________________________________ parentesco:
_____________ Fecha en la que se reporta la agresión: _________________ Fecha desde que se está dando la
agresión: _________________________ La había reportado? SI: _______ NO: ______ Porque: _____________
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A quien reporto: ____________________________________________________________________________

VERSION DE QUIN REPORTA LA AGRESION.

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La persona que reporta la agresión se compromete a reportar nuevamente a coordinación

de la situación continúa presentándose.
Firma de quien reporta: ___________________ cc: ___________ Celular: _____________

5. CONTACTO DIRECTO CON LA PERSONA AGREDIDA

FECHA: __________________ NOMBRE: ____________________________ GRADO: _____
Fecha en la que reporta la agresión: __________________ Fecha desde que se está dando la agresión
___________________________ La había reportado: si ________ no _________ porque
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a quien _____________________________________________________________________________________

VERSION DE LA PERSONA AGREDIDA:

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6. CONTACTO DIRECTO CON LOS AGRESORES
Fecha: ____________ Nombre: ____________________________________ Grado: ____________

Versión del agresor:

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A la persona acusada de la agresión se le notifica que si se presenta una nueva agresión o intimidación verbal,
física o virtual será citado el acudiente y se le aplicaran los correctivos el manual de convivencia; se compromete
a:
____________________________________________________________________________________________
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Firma: _____________________________ Celular acudiente: _______________________

7. REMISION A PSICOORIENTACION
FECHA: ____________________

CONCEPTO DE LA PSICOORIENTADORA:
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 Firma psico-orientadora: ___________________________________ CC: _______________
8. Madre de familia

9. NUEVO CONTACTO CON LOS AGRESORES:

Fecha: ___________________ Nombre: ___________________________________ Grado: _______

VERSION ACERCA DE LA AGRESION:

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Firma del reportado: __________________________________ Celular acudiente:

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10. CONTACTO DIRECTO CON LOS ACUDIENTES:

Fecha: __________________ Nombre: ____________________________________________

Compromiso:
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Se informa que de continuar la agresión se tomara la medida correctiva respectiva, el conducto regular y el
debido proceso que puede provocar la suspensión, perdida de la convivencia, reporte en la plataforma Siuse,
remisión al comité de convivencia, remisión al consejo directivo para suspensión de la matricula y remisión a la
autoridad competente.
Firma del acudiente: ______________________________________ CC: ____________________
 Firma del estudiante: __________________________ Celular del acudiente:
________________

11. REPORTE DE NUEVOS HECHOS

Fecha: ____________ Persona que reporta la agresión: ______________________ Parentesco:
_______________

VERSION DE QUIEN REPORTA LA AGRESION:

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La persona que reporta la agresión se compromete a reportar nuevamente a coordinación

de la situación continúa presentándose.
Firma de quien reporta: ___________________ cc: ___________ Celular: _____________

12. NUEVO CONTACTO CON LOS AGRESORES

VERSION ACERCA DE LA AGRESION:

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Firma del reportado: ____________________________________ Celular acudiente: _________________

13. CONTACTO DIRECTO CON LOS ACUDIENTES:

Fecha: ________________ Nombre: ____________________________________________
Medida Correctiva respectiva:
Suspensión, reparación a la víctima, remisión al comité de conciliación.
Compromiso:
____________________________________________________________________________________________
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Firma del estudiante: _____________________________ Celular del acudiente: ______________

14. REMISON AL COMITÉ DE CONCICLIACION

Fecha: _________________

CONCLUSIONES DE LA CONCICLIACION:
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Firma de las partes: ___________________________________________________________________________

Firma de los conciliadores: _____________________________________________________________________

15. REPORTE DE NUEVOS HECHOS:

Fecha: _______________ Persona que reporta la agresión: _______________________ Parentesco: __________

VERSION DE QUIEN REPORTA LA AGRESION:

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La persona que reporta la agresión se compromete a reportar nuevamente a coordinación si la situación

continúa presentándose.
Firma de quien reporta: ________________________ cc: ______________ Celular: _____________________

16. NUEVO CONTACTO CON LOS AGRESORES

Fecha: ________________________ Nombre: _____________________________ Grado: _________________

VERSION ACERCA DE LA AGRESION:

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Firma del reportado: ____________________________________ Celular acudiente: _________________

17. CONTACTO DIRECTO CON LOS ACUDIENTES:

Fecha: ________________ Nombre: ____________________________________________
Medida Correctiva respectiva:
 Suspensión, reparación a la víctima, remisión al comité de convivencia escolar.
Compromiso:
____________________________________________________________________________________________
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Firma del estudiante: _____________________________ Celular del acudiente: ______________

18. REMISION AL COMITÉ DE CONVIVENCIA ESCOLAR
Fecha: ________________________

CONCLUSIONES DEL COMITÉ DE CONVIVENCIA ESCOLAR

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Firma De los integrantes del comité de convivencia escolar:

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19. REPORTE DE NUEVOS HECHOS:
Fecha: _______________ Persona que reporta la agresión: _______________________ Parentesco: __________

VERSION DE QUIEN REPORTA LA AGRESION:

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La persona que reporta la agresión se compromete a reportar nuevamente a coordinación si la situación

continúa presentándose.
Firma de quien reporta: ________________________ cc: ______________ Celular: _____________________

20. NUEVO CONTACTO CON LOS AGRESORES

Fecha: ________________________ Nombre: _____________________________ Grado: _________________

VERSION ACERCA DE LA AGRESION:

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Firma del reportado: ____________________________________ Celular acudiente: _________________

21. CONTACTO DIRECTO CON LOS ACUDIENTES:
Fecha: ________________ Nombre: ____________________________________________
Medida Correctiva respectiva:
Suspensión, reparación a la víctima, remisión al consejo directivo para cancelación de la matricula, remisión del
caso por parte del rector a la autoridad competente y relación del caso a la plataforma Siuse.
Compromiso:
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Firma del estudiante: _____________________________ Celular del acudiente: ______________

22. REMISION POR PARTE DEL RECTOR A LA AUTORIDAD COMPETENTE Y PUBLICACION EN LA PLATAFORMA
SIUSE
Fecha: ________________________

CONCLUSIONES DE LA AUTORIDAD COMPETENTE

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Nombre de la autoridad competente: ____________________________________ Cargo:

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Firma de la autoridad competente: _________________________________ CC :
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Dirección: __________________________________________________ Celular:
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