Report a Workplace Violent Incident

“Threat of violence” means any verbal or written statement, including, but not limited to, texts, electronic messages, social media messages, or other online posts, or any behavioral or physical conduct, that conveys an intent, or that is reasonably perceived to convey an intent, to cause physical harm or to place someone in fear of physical harm, and that serves no legitimate purpose.

If you are concerned that someone in your work area seems unstable or poses a violence risk, even if it is not directed at you, use this form to report it. Early intervention may prevent a violent act from happening.

“Workplace violence” includes, but is not limited to, the following:

• The threat or use of physical force against an employee that results in, or has a high likelihood of resulting in, injury, psychological trauma, or stress, regardless of whether the employee sustains an injury.
• An incident involving a threat or use of a firearm or other dangerous weapon, including the use of common objects as weapons, regardless of whether the employee sustains an injury.

Workplace violence takes several forms, including verbal threats, threatening behavior, or physical assaults. The Labor Code has classified such an incident by 'type' depending on the relationship of the perpetrator to the worker or the workplace.

Type 1: Workplace violence committed by a person who has no legitimate business at the worksite, and includes violent acts by anyone who enters the workplace or approaches workers with the intent to commit a crime.

• Perpetrator Type: Stranger

Type 2: Workplace violence directed at employees by a person who does have legitimate business at the worksite.

• Perpetrator Type: Student, Visitor, Consultant, Contractor, Vendor, Patient

Type 3: Workplace violence against an employee by a present or former employee, supervisor, or manager.

• Perpetrator Type: Another Employee, Lead, Supervisor, Manager, Principal Investigator

Type 4: Workplace violence committed in the workplace by a person who does not work there, but has or is known to have had a personal relationship with an employee

• Perpetrator Type: Family member, current or former spouse, partner, friend, acquaintance

The perpetrator types listed are the most common examples. Choose the type that most closely matches the perpetrator and one of the four types of workplace violence listed.

Reporting Process

The online form available on this page is the means by which violent incidents that occur in the workplace are reported and investigated. Information on this reporting form will be used to create an entry on the Workplace Violent Incident Log (Log). The Log will not contain identifying information of the people involved.

Fill out the online Report of a Workplace Violent Incident form available on this page.

• Managers and supervisors who become aware of a workplace violent incident must report it using the online form.
• Employees may do so anonymously, but the report can be more effectively investigated if contact information is provided.  We may have questions and would like a means of getting back to them about the investigation findings.

When finished, select the SUBMIT button. It will be forwarded to the WVPP Records Administrator for review and processing.

EH&S will conduct the initial investigation and bring in other relevant university groups as needed.

See the SFSU Workplace Violence Prevention Plan, Section VIII for more information about this process.

Alternate Reporting

• A fill-in form you can download and print is also available and can be given to EH&S, HR, Equity, or other campus representative.
• Contact the EH&S office by telephone at 415.338.2565 or email.
• Report to your supervisor, manager, or other university representative, such as University Police, Title IX/Equity or HR, who can then fill out this form to report the incident.
• Incidents reported as part of other university programs that meet the definition of "workplace violent incident", will also be reported using the online form to provide consistency in reporting under the WVPP.

Report of a Workplace Violent Incident

This reporting form is intended to start the investigation process. The information will be used to investigate the incident, so the names of people involved and other details are important. Other campus groups investigating the same incident may submit duplicate incident reports. The WVPP Records Administrator will combine reported information relevant to a particular incident into an entry on the Workplace Violent Incident Log (Log).

Workplace Violent Incident Log

The Log is a requirement of the California Labor Code Section 6401.9, the workplace violence prevention plan law. It tracks the frequency and types of incidents that are occurring at a place of employment. Information such as incident date, time and location, consequences of the incident, and steps taken to protect employees from further threat or hazards are included on the Log.

• The Log must exclude personal identifying information that would identify any person involved in a violent incident in the workplace.