EXHIBIT D 
SUPERVISOR/ADMINISTRATOR REPORT OF LEVEL ONE CONFERENCE

1. Complainant’s Name: __________________________________
2. Position/Campus:____________________________________
3. Date and Time of Conference: _________________
4. Set forth the facts as presented by the complainant: __________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ 5. In your opinion, were the allegations made in the original complaint adequately supported by the facts submitted? 
__Yes ___No
6. In your opinion, is the remedy sought by the complainant justified by the facts submitted? __Yes __No
Please explain: _________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ 7. What decisions were made or recommendations agreed upon as a result of the conference? 
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

  _____________________________                _____________
Signature of Supervisor/Administrator                  Date Attach a copy of the complainant’s original written complaint (Exhibit A) and a copy of the written response from the supervisor/administrator before submitting. Received by:

________________________                           ______________
Superintendent                                                      Date