License Exempt Provider Serious Injury Report

         
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
Type
PDF
Age Groups
Five'sFour'sInfant/ToddlerKindergartenMixed AgesPreschoolSchool AgeThree'sTwo's
Price
Free
License: CC0/PUBLIC DOMAIN
Need help? Call us at 1(833)283-2241 (2TEACH1)
Call us