Exhibit H Submitting an Incident Report vs. Calling the Hotline.docx
DOCX document 32 KB Posted
- Attached to
- Master Agreement AZ|CTR056498
- Contract number
- CTR056498
- Issued by
- Arizona
About this file
The document is an incident reporting matrix from the State of Arizona Department of Child Safety, Office of Procurement, located in Phoenix, Arizona. It details a comprehensive guide for reporting various critical incidents involving children in care, specifying whether an incident requires an official incident report, a hotline call, or both.
The matrix covers 24 distinct incident types, including but not limited to individual deaths, suicide-related incidents, physical and sexual abuse allegations, medical emergencies, injuries, hospitalizations, physical aggression, property damage, substance abuse, police involvement, emergency evacuations, and child runaways. Each incident type is categorized with specific reporting requirements, indicating whether a formal incident report, a hotline call, or both are necessary, providing a structured approach to documenting and communicating critical events in child care settings.
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Text version
SUBMITTING AN INCIDENT REPORT VS. CALLING THE HOTLINE
State of Arizona Department of Child Safety Office of Procurement 3003 N. Central Ave Phoenix, AZ 85012
| Incident Report |
| Call to Hotline |
| 1. Individual deaths |
| X |
| X |
| 2. Suicide ideation |
| X |
| 3. Suicide attempt |
| X |
| X |
| 4. Self-harm |
| X |
| 5. Physical abuse and allegations of physical abuse; |
| X |
| X |
| 6. Sexual abuse and allegations of sexual abuse; |
| X |
| X |
| 7. Sexual contact or physical aggression between children |
| X |
| 8. Any incident involving injury or trauma (i.e. accidents) regardless of treatment location; |
| X |
| 9. When medicine is administered in an emergency situation; |
| X |
| 10. Errors in administering medications requiring emergency medical intervention; |
| X |
| X |
| 11. Adverse medication reactions resulting in medical intervention; |
| X |
| 12. When a child in care suffers an injury, illness, or psychiatric episode that is severe enough to require hospitalization |
| X |
| X |
| 13. Accidents occurring in the treatment facility or off-site, while under the supervision of the treatment facility's staff, requiring emergency medical treatment, which are not limited to near drowning that require resuscitation. |
| X |
| X |
| 14. Threats and/or altercation with parent, staff or child(ren); |
| X |
| 15. Assault, Fighting or Physical Aggression |
| X |
| 16. Damage or theft of property; |
| X |
| 17. Substance Abuse |
| X |
| 18. Police involvement; |
| X |
| 19. Emergency Evacuations |
| X |
| X |
| 20. Transportation/traffic related incidents |
| X |
| 21. Disasters, such as major fire in the facility when children were present or which affect individual care areas; |
| X |
| X |
| 22. Child is arrested |
| X |
| X |
| 23. When a physical restraint is used; and |
| X |
| 24. When a child(ren) is determined to be a runaway. |
| X |
| X |
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