1. Incident Summary

Tip: Accident, Injury, Near Miss, Property Damage, etc.

Tip: Particularly in the context of protecting children from abuse, neglect, exploitation, and unsafe practices.

2. Reporting Person

3. Incident Description

4. Hazards

5. Individuals involved

6. Witnesses

7. Actions Taken

Tip: e.g. Medical or first aid assistance, Reporting to authorities, No action taken, etc.

8. Additional Comments

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Office use only

Checklist

  1. Risk and Compliances Standing Committee Chair has been notified ofthe Report
  2. Report saved to designated OneDrive folder
  3. Retention

Risk and Compliance Standing Committee Use Only

Person(s) responsible for actioning the aboveĀ