General Incident Report in Childcare Example [Edit & Download]

1. Title

• Childcare Incident Report

2. Basic Information

• Date of Report: [Insert date]
• Time of Incident: [Insert time]
• Date of Incident: [Insert date]
• Location of Incident: [Insert location, e.g., playground, classroom]
• Reported By: [Insert staff member’s name]
• Role/Position: [Insert role, e.g., Teacher, Assistant Caregiver]

3. Child’s Information

• Child’s Name: [Insert child’s name]
• Age: [Insert child’s age]
• Classroom/Group: [Insert group or room name]

4. Description of Incident

• Type of Incident: [e.g., injury, behavioral incident, medical emergency]
• Details:
  • What happened? (Provide a detailed account of the incident).
  • Who was involved? (List other children, staff, or individuals present).
  • When and where did it occur?
  • How was the child affected? (Describe injuries, emotional response, or other outcomes).

5. Immediate Actions Taken

• Response by Staff:
  • Steps taken immediately after the incident (e.g., applying first aid, comforting the child).
  • Communication with parents/guardians (e.g., phone call, written notification).
  • External assistance (e.g., calling emergency services if needed).

6. Observations/Findings

• Environmental Factors: [e.g., wet floors, toys, or equipment involved].
• Behavioral Factors: [e.g., running, conflict with another child].

7. Follow-Up Actions

• Measures to prevent recurrence (e.g., repair of equipment, additional supervision).
• Additional communication with parents/guardians regarding updates or follow-up care.

8. Attachments (if applicable)

• Photos, witness statements, or other supporting documentation.

9. Signatures

• Reported By: [Name, Signature, Date]
• Reviewed By: [Supervisor/Manager Name, Signature, Date]

10. Follow-Up Section (if applicable)

• Resolution Actions: Describe steps taken post-incident to resolve or prevent recurrence.
• Date of Completion: [Insert date].
• Responsible Team/Person: [Name and role].