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 the Clery Act and California Education Code.

If you are concerned for the safety of any of the involved parties

or other members of the community,

CALL 909-274-4555 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 the victim if they want 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 California Education Code. Call the Mt. San Antonio College Police and Campus Safety Department (P&CS) at 909-274-4555 and ask for an officer to contact you. In all cases, P&CS will assist, even if the crime occurred off campus. Neither the California Education Code nor the Clery Act require CSAs to report names of victims or suspects.

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

Call 909-274-5249 to reach the Title IX Office.

(This number is not answered 24/7; after-hours messages will receive return calls promptly.)

Murder/Non-Negligent Manslaughter: the willful (non-negligent) killing of one human being by another.

Manslaughter by Negligence: the killing of another person through gross negligence.

Rape: the penetration, however slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ, without consent, including when the victim is incapable of giving consent (includes the rape of both males and females).

Fondling: the touching of the private body parts of another person for the purpose of sexual gratification, without consent, including when the victim is incapable of giving consent.

Incest: sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law (in California: parents and children, ancestors and descendants of every degree, brothers and sisters of any degree — including half-brothers and half-sisters — and uncles or aunts with nieces or nephews).

Statutory Rape: sexual intercourse with a person who is under the statutory age of consent (in California: under 18). (Note: If force is used or threatened, or the victim was incapable of giving consent because of the victim’s age or temporary or permanent or mental impairment, the offense is Rape, not Statutory Rape).

Robbery: the taking or attempting to take anything from value from the care, custody, or control of a person or persons by force or threat of force or violence and/or by putting the victim in fear.

Aggravated Assault: an unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury. This type of assault usually is accompanied by the use of a weapon or by means likely to produce death or great bodily harm.

Burglary: the unlawful entry of a structure to commit a felony or a theft. (A structure has four walls, a roof, and a door.)

Motor Vehicle Theft: the theft or attempted theft of a motor vehicle. (Classify as motor vehicle theft all cases where automobiles are taken by person not having lawful access, even though the vehicles are later abandoned - including joy riding).

Arson: any willful or malicious burning or attempt to burn, with or without intent to defraud, a dwelling house, public building, motor vehicle or aircraft, or personal property of another.

Mt. San Antonio College 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.

Larceny: the unlawful taking, carrying, leading, or riding away of property from the possession or constructive possession of another. (Constructive possession is the condition in which a person does not have physical custody or possession but is in a position to exercise dominion of control over a thing.)

Simple Assault: an unlawful physical attack by one person upon another where neither the offender displays a weapon, nor the victim suffers obvious severe or aggravated bodily injury involving apparent broken bones, loss of teeth, possible internal injury, severe laceration or loss of consciousness.

Intimidation: to unlawfully place another person in reasonable fear of bodily harm through the use of threatening words and/or other conduct, but without displaying a weapon or subjecting the victim to actual physical attack.

Destruction/Damage/Vandalism of Property: to willfully or maliciously destroy, injure, disfigure, or deface any public or private property, real or personal, without the consent of the owner or person having custody or control by cutting, tearing, breaking, marking, painting, drawing, covering with filth, or any other such means as may be specified by local law.

Domestic Violence: felony or misdemeanor crimes of violence committed by a current or former spouse or intimate partner of the victim, by a person with whom the victim shares a child in common, by a person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner, by a person similarly situated to a spouse of the victim (i.e., domestic partnership), or by any other person against an adult or youth victim who is protected from that person's acts under the domestic or family violence laws of the jurisdiction where the crime occurred.

Dating Violence: violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim; and where the existence of such a relationship shall be determined based on a consideration of the following factors:(i) the length of the relationship; (ii) the type of relationship; (iii) the frequency of interaction between the persons involved in the relationship.

Stalking: engaging in a course of conduct directed at a specific person that would cause a reasonable person to fear for the person’s safety or the safety of others, or suffer substantial emotional distress.

Weapon Law Violations: the unlawful possession or control of any firearm, deadly weapon, (including nunchakus or billy club) illegal knife or explosive device while on college property, except as required in the lawful course of business or as authorized by the Campus Police; the unlawful manufacture, sale, purchase, transportation, possession, concealment, or use of firearms, cutting instruments, explosives, incendiary devices or other deadly weapons.

Drug Law Violations: the unlawful possession, sale, use, transportation, growing, cultivation, manufacturing, making, distribution, purchase, importation of any controlled drug or narcotic substance; violations of laws prohibiting use of the equipment or devices utilized in their preparation and/or use.

Alcohol Law Violations: the unlawful possession, sale, transportation, manufacturing, purchase, or use of alcoholic beverages; furnishing alcohol to a minor (under 21 years); maintaining unlawful drinking places; bootlegging; operating a still; using a vehicle for illegal transportation of liquor; drinking on a train or public conveyance; and attempts to commit any of the above. (Drunkenness and driving under the influence are not included in this definition

Hazing: any intentional, knowing, or reckless act committed by a person against a student (regardless of that student's willingness to participate), that (1) is connected with an initiation into, an affiliation with, or the maintenance of membership in, an organization (e.g., a club, athletic team, fraternity, or sorority); and (2) causes or is likely to contribute to a substantial risk, above the reasonable risk encountered in the course of participation in the college or the organization, of physical injury, mental harm, or degradation.

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

Check all that apply.

If a Hate Crime occurred, please check “Hate Crime” as well as the crime that occurred.

Please respond to the following questions:

Be sure to ask the victim the following question and document the response.