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License Exempt Provider Serious Injury Report
Type: PDF
License: CC0/PUBLIC DOMAIN
Description: Use this official reporting form to document serious injuries or deaths that occur in a license-exempt child care setting serving children who receive child care subsidy. The form includes incident details, injury type, hospital involvement, parent notification, and reporting instructions for the Child Development and Care office. #SeriousInjuryReport #ChildCareSafety #LicenseExemptProvider #IncidentReporting #ChildCareSubsidy #HealthAndSafety #ProviderForms #ECE
Age Groups:
Five'sFour'sInfant/ToddlerKindergartenMixed AgesPreschoolSchool AgeThree'sTwo'sTopic Areas:
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