Accident/Incident/Trauma (AIT) Policy for Early Childhood Educator Certificate III
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This Accident/Incident/Trauma (AIT) Policy is for Early Childhood Educator Certificate III. It includes forms and procedures for immediate medical aid and treatment due to serious illness, trauma accident or injury.
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VOCATIONAL PLACEMENT:
(EARLY CHILDHOOD EDUCATOR Certificate
III) Accident/Incident/Trauma (AIT) Policy
Position Title: Early Childhood Educator (Certificate III)
Name of
Preschool/ Long
Day Care:
Responsible to: Vocational Workplace Supervisor
Requirements: Current First Aid Certificate,
Anaphylaxis and
Asthma Management training
In fulfilment of the relevant requirements leading to the
qualification:
(EARLY CHILDHOOD EDUCATOR Certificate
III) Accident/Incident/Trauma (AIT) Policy
Position Title: Early Childhood Educator (Certificate III)
Name of
Preschool/ Long
Day Care:
Responsible to: Vocational Workplace Supervisor
Requirements: Current First Aid Certificate,
Anaphylaxis and
Asthma Management training
In fulfilment of the relevant requirements leading to the
qualification:
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CHC30113 Certificate III in Early Childhood Education and
Care
Accident/Incident/Trauma
Care
Accident/Incident/Trauma
Contents
Introduction........................................................................................................................................... 3
Accident/Incident/Trauma Policy........................................................................................................... 3
FORMS................................................................................................................................................. 4
1. FORM A: Accident Report Summary.........................................................................................4
2. FORM B - Minor Accident and Incident Report..........................................................................4
3. FORM C - Client in Care Incident / Trauma Injury Form............................................................4
4. FORM D – Accident at Home Form...........................................................................................4
5. FORM E – FAMILY DAY CARE INSURANCE FORM:..............................................................4
6. FORM F – PROFESSIONAL INDEMNITY.................................................................................4
7. FORM G - (NL01) ACECQA NOTIFICATION OF COMPLAINTS AND INCIDENTS (OTHER
THAN SERIOUS INCIDENT)............................................................................................................. 5
8. FORM H - (SIO1) ACECQA NOTIFICATION OF SERIOUS INCIDENT....................................5
FORM A: ACCIDENT REPORT SUMMARY FOR THE MONTH OF _________.................................6
FORM B: Minor Accident and Incident Record (Not requiring Doctor’s visit or hospitalisation)............7
FORM C: CLIENT IN CARE INCIDENT/INJURY REPORT (NEEDING MEDICAL TREATMENT)......8
FORM D: Accident At Home – record of injury not occurring in care...................................................10
FORM E: Professional Indemnity Notification......................................................................................11
INJURY/ INCIDENT LETTER.............................................................................................................. 12
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 2
Introduction........................................................................................................................................... 3
Accident/Incident/Trauma Policy........................................................................................................... 3
FORMS................................................................................................................................................. 4
1. FORM A: Accident Report Summary.........................................................................................4
2. FORM B - Minor Accident and Incident Report..........................................................................4
3. FORM C - Client in Care Incident / Trauma Injury Form............................................................4
4. FORM D – Accident at Home Form...........................................................................................4
5. FORM E – FAMILY DAY CARE INSURANCE FORM:..............................................................4
6. FORM F – PROFESSIONAL INDEMNITY.................................................................................4
7. FORM G - (NL01) ACECQA NOTIFICATION OF COMPLAINTS AND INCIDENTS (OTHER
THAN SERIOUS INCIDENT)............................................................................................................. 5
8. FORM H - (SIO1) ACECQA NOTIFICATION OF SERIOUS INCIDENT....................................5
FORM A: ACCIDENT REPORT SUMMARY FOR THE MONTH OF _________.................................6
FORM B: Minor Accident and Incident Record (Not requiring Doctor’s visit or hospitalisation)............7
FORM C: CLIENT IN CARE INCIDENT/INJURY REPORT (NEEDING MEDICAL TREATMENT)......8
FORM D: Accident At Home – record of injury not occurring in care...................................................10
FORM E: Professional Indemnity Notification......................................................................................11
INJURY/ INCIDENT LETTER.............................................................................................................. 12
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 2
INTRODUCTION
“To ensure the safety of all clients, parents, young people and children, educators, general public,
volunteers and students and to provide a procedure and reporting system for immediate medical
aid and if necessary medical treatment due to serious illness, trauma accident or injury”
“To ensure that the parent/guardian or next of kin is notified as soon as possible and that they
are returned to their care”.
ACCIDENT/INCIDENT/TRAUMA POLICY
• Access the extent of injury, provide first aid as soon as possible and contact parent or seek
medical attention if required.
• Children are to be carefully supervised until parents arrive or medical treatment is obtained.
• All Educators in Children’s Services must have a current first aid certificate.
• Educator must wear disposable gloves when dealing with bodily fluids and administering First Aid.
• Materials used to clean wounds will be disposed of immediately; bloodied materials are to be
disposed of in sanitary bins which are inaccessible to children. (For serious injuries, keep blood
soaked cloths on wounds and continue to add more on top until medical assistance is obtained
to monitor blood loss and not disturb the wounds).
• Educators in Child Care Centres are to report accidents/incidents to Supervisor immediately. Family
Day Care Educators report to Coordination Unit.
• If the accident requires the child to be taken by an ambulance an educator will accompany the
injured child to the hospital and will continue to remain with the child until a parent of the child or other
emergency contact arrives to take care of the child. Remain with the child when doctor is there as
often they will not stay for long and child must never be left alone. Contact the Manager Children’s of
Services to advise of incident.
• All accidents that require medical treatment are to be reported to Australian Children’s Education &
Care Quality Authority, (ACECQA) within 24 hours.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 3
“To ensure the safety of all clients, parents, young people and children, educators, general public,
volunteers and students and to provide a procedure and reporting system for immediate medical
aid and if necessary medical treatment due to serious illness, trauma accident or injury”
“To ensure that the parent/guardian or next of kin is notified as soon as possible and that they
are returned to their care”.
ACCIDENT/INCIDENT/TRAUMA POLICY
• Access the extent of injury, provide first aid as soon as possible and contact parent or seek
medical attention if required.
• Children are to be carefully supervised until parents arrive or medical treatment is obtained.
• All Educators in Children’s Services must have a current first aid certificate.
• Educator must wear disposable gloves when dealing with bodily fluids and administering First Aid.
• Materials used to clean wounds will be disposed of immediately; bloodied materials are to be
disposed of in sanitary bins which are inaccessible to children. (For serious injuries, keep blood
soaked cloths on wounds and continue to add more on top until medical assistance is obtained
to monitor blood loss and not disturb the wounds).
• Educators in Child Care Centres are to report accidents/incidents to Supervisor immediately. Family
Day Care Educators report to Coordination Unit.
• If the accident requires the child to be taken by an ambulance an educator will accompany the
injured child to the hospital and will continue to remain with the child until a parent of the child or other
emergency contact arrives to take care of the child. Remain with the child when doctor is there as
often they will not stay for long and child must never be left alone. Contact the Manager Children’s of
Services to advise of incident.
• All accidents that require medical treatment are to be reported to Australian Children’s Education &
Care Quality Authority, (ACECQA) within 24 hours.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 3
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FORMS
1. FORM A: Accident Report Summary
The Centre Director completes this form in the Children’s Services Section monthly to assess
the accidents for reduction of similar incidents.
2. FORM B - Minor Accident and Incident Report
This form is to be completed when any minor incident or injury occurs to a child. The
parent/guardian or carer will be notified when the child is collected and signs this form, a copy of this
form can be given to parent/guardian if requested. The form is then filed in the child’s records. This
form is designed to list incidents so any reoccurrence or pattern can be recorded. All children will
have their own form.
3. FORM C - Client in Care Incident / Trauma Injury Form
This form is to be completed electronically by Centre Director (Nominated Supervisor) or by the
supervisor at the time of the injury (if medical attention is required) and then emailed to the
Children’s Services Liaison Officer or the School Aged Liaison Officer. Give a copy of this form to the
parent when signed off by the Manager. An electronic copy should be electronically saved to the
incident file on TRIM Sub3 and electronically to the child’s file on TRIM.
This form needs to be forwarded to the ACECQA within 24 hours by CSLO/SALO after all other
parties have completed.
4. FORM D – Accident at Home Form
This form is completed by an Educator when a child presents for care with an injury that did not
occur at the service. It should be completed and kept in the child’s file at Centre and electronically
saved to child’s file.
5. FORM E – FAMILY DAY CARE INSURANCE FORM:
For Educators to complete when they have an accident or when child in care has an
accident requiring medical attention.
6. FORM F – PROFESSIONAL INDEMNITY
a) If you give your professional opinion to a client or the general public and it is given in good
faith, but the outcome for the client or general public is not positive, you must register yours
and their comments on this form.
b) If a client or member of the general public wishes to lodge a complaint then this form
should be filled in.
c) The form should be forwarded to the Manager.
d) The Manager will pass the form onto the Insurance Officer.
e) Optional – Phone Log Books are a good way of recording all in and outgoing information.
If you wish to use the Phone Log please contact your Manager for a copy.
This form is to be used to record any incidences where injuries are for staff.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 4
1. FORM A: Accident Report Summary
The Centre Director completes this form in the Children’s Services Section monthly to assess
the accidents for reduction of similar incidents.
2. FORM B - Minor Accident and Incident Report
This form is to be completed when any minor incident or injury occurs to a child. The
parent/guardian or carer will be notified when the child is collected and signs this form, a copy of this
form can be given to parent/guardian if requested. The form is then filed in the child’s records. This
form is designed to list incidents so any reoccurrence or pattern can be recorded. All children will
have their own form.
3. FORM C - Client in Care Incident / Trauma Injury Form
This form is to be completed electronically by Centre Director (Nominated Supervisor) or by the
supervisor at the time of the injury (if medical attention is required) and then emailed to the
Children’s Services Liaison Officer or the School Aged Liaison Officer. Give a copy of this form to the
parent when signed off by the Manager. An electronic copy should be electronically saved to the
incident file on TRIM Sub3 and electronically to the child’s file on TRIM.
This form needs to be forwarded to the ACECQA within 24 hours by CSLO/SALO after all other
parties have completed.
4. FORM D – Accident at Home Form
This form is completed by an Educator when a child presents for care with an injury that did not
occur at the service. It should be completed and kept in the child’s file at Centre and electronically
saved to child’s file.
5. FORM E – FAMILY DAY CARE INSURANCE FORM:
For Educators to complete when they have an accident or when child in care has an
accident requiring medical attention.
6. FORM F – PROFESSIONAL INDEMNITY
a) If you give your professional opinion to a client or the general public and it is given in good
faith, but the outcome for the client or general public is not positive, you must register yours
and their comments on this form.
b) If a client or member of the general public wishes to lodge a complaint then this form
should be filled in.
c) The form should be forwarded to the Manager.
d) The Manager will pass the form onto the Insurance Officer.
e) Optional – Phone Log Books are a good way of recording all in and outgoing information.
If you wish to use the Phone Log please contact your Manager for a copy.
This form is to be used to record any incidences where injuries are for staff.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 4
7. FORM G - (NL01) ACECQA NOTIFICATION OF COMPLAINTS
AND INCIDENTS (OTHER THAN SERIOUS INCIDENT)
To notify if incident/complaint occurs that compromises the wellbeing of children in care of the
provision of care provided by approved provider. Forms can be located on: www.acecqa.gov.au
8. FORM H - (SIO1) ACECQA NOTIFICATION OF SERIOUS
INCIDENT
To be submitted after a Form C is lodged to CSLO then this form must be completed and submitted
to ACECQA.
Forms can be located on: www.acecqa.gov.au
STAFF:
Staff refers to those employed by Sparkling Stars Childcare Centre. If a staff member injures him
or herself, or complains of headaches, sore back, or has a near miss:
• The staff member should notify their direct supervisor immediately.
• Employee Accident, Incident, Near Miss and Dangerous Occurrences completing the
online OHS form within 24 hours of accident.
• All staff will be provided with lifting and bending information and manual handling training.
GENERAL PUBLIC - General public refers to everyone else other than staff and clients
in care
If a member of the general public enters our premises and is injured:
a) They would notify the nearest staff person.
b) The staff person would notify the Supervisor.
c) The Supervisor will ring the Manager.
d) The Supervisor will fill out the Sparkling Stars Childcare Centre Insurance Incident Report
GENERAL NOTES
• If medical attention is required, emergency procedures take precedence.
• Keep copies of everything.
• Do not give copies of anything to anyone – refer them to Sparkling Stars Chidlcare Centre’s
Risk Manager – 9840 9747.
• All forms should be completed and sent up to your Manager as soon as possible (within 24
hours is ideal) within two days is acceptable.
• If you feel a client is not being appropriately cared for whilst in the building or outdoor area it
is the responsibility of the staff member to tell the client and parent/guardian that the
behaviour is not allowed whilst in our care or on our premises.
• Parents are required to provide written authority (included in the Enrolment Form) to
the Family Day Care Educator/ Scheme/Centre to seek medical attention for their child
if required.
• All reasonable steps will be taken to provide immediate medical aid to a child if necessary.
• Educators should act on their discretion in the application of first aid or resuscitation and in
the decision to contact the child’s own doctor, or the closest doctor, or an ambulance. Other
Educators will assist where possible.
• Parent/ Guardian will be notified by phone of injuries that require first aid.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
AND INCIDENTS (OTHER THAN SERIOUS INCIDENT)
To notify if incident/complaint occurs that compromises the wellbeing of children in care of the
provision of care provided by approved provider. Forms can be located on: www.acecqa.gov.au
8. FORM H - (SIO1) ACECQA NOTIFICATION OF SERIOUS
INCIDENT
To be submitted after a Form C is lodged to CSLO then this form must be completed and submitted
to ACECQA.
Forms can be located on: www.acecqa.gov.au
STAFF:
Staff refers to those employed by Sparkling Stars Childcare Centre. If a staff member injures him
or herself, or complains of headaches, sore back, or has a near miss:
• The staff member should notify their direct supervisor immediately.
• Employee Accident, Incident, Near Miss and Dangerous Occurrences completing the
online OHS form within 24 hours of accident.
• All staff will be provided with lifting and bending information and manual handling training.
GENERAL PUBLIC - General public refers to everyone else other than staff and clients
in care
If a member of the general public enters our premises and is injured:
a) They would notify the nearest staff person.
b) The staff person would notify the Supervisor.
c) The Supervisor will ring the Manager.
d) The Supervisor will fill out the Sparkling Stars Childcare Centre Insurance Incident Report
GENERAL NOTES
• If medical attention is required, emergency procedures take precedence.
• Keep copies of everything.
• Do not give copies of anything to anyone – refer them to Sparkling Stars Chidlcare Centre’s
Risk Manager – 9840 9747.
• All forms should be completed and sent up to your Manager as soon as possible (within 24
hours is ideal) within two days is acceptable.
• If you feel a client is not being appropriately cared for whilst in the building or outdoor area it
is the responsibility of the staff member to tell the client and parent/guardian that the
behaviour is not allowed whilst in our care or on our premises.
• Parents are required to provide written authority (included in the Enrolment Form) to
the Family Day Care Educator/ Scheme/Centre to seek medical attention for their child
if required.
• All reasonable steps will be taken to provide immediate medical aid to a child if necessary.
• Educators should act on their discretion in the application of first aid or resuscitation and in
the decision to contact the child’s own doctor, or the closest doctor, or an ambulance. Other
Educators will assist where possible.
• Parent/ Guardian will be notified by phone of injuries that require first aid.
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 5
2014 Page 5
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FORM A: ACCIDENT REPORT SUMMARY FOR THE MONTH OF _________
Day/Date/Time Details Location of First Aid Evaluation Strategies
Accident What/Where/Who
Printable Version: FORM A
Day/Date/Time Details Location of First Aid Evaluation Strategies
Accident What/Where/Who
Printable Version: FORM A
FORM B: MINOR ACCIDENT AND INCIDENT RECORD
(NOT REQUIRING DOCTOR’S VISIT OR HOSPITALISATION)
Child’s Name: Billy
DOB:5 Aug
2012
Educator’s Director/
Location First Aid Coordinator’s Parent
Date Time Details name and Comments
of
accident Administered name and signature
signature signature
Please
Insert
Please
Insert
Consumption of allergic
food At home Not required Insert Insert Insert
Printable Version: FORM B
(NOT REQUIRING DOCTOR’S VISIT OR HOSPITALISATION)
Child’s Name: Billy
DOB:5 Aug
2012
Educator’s Director/
Location First Aid Coordinator’s Parent
Date Time Details name and Comments
of
accident Administered name and signature
signature signature
Please
Insert
Please
Insert
Consumption of allergic
food At home Not required Insert Insert Insert
Printable Version: FORM B
FORM C: CLIENT IN CARE INCIDENT/INJURY REPORT
(NEEDING MEDICAL TREATMENT)
To be completed in all cases of accidents requiring medical attention or where there is concern.
Complete electronically and forward to the Manager within 24 hours.
Full Name of Client:
Date of Birth:
Parent’s/Guardian
Name:
Address Postcode:
Telephone:
Date and Time of
Accident:
Where accident
occurred:
Description of How
Accident Occurred:
First aid given:
First Aid Administered
by:
Nature of Injury:
Was Medical Attention Yes By Whom?:
Recommended? No
YES/NO
Was Medical Attention Yes By Whom?:
Secured? YES/NO No
Name of Medical
Centre/Hospital:
Name of Doctor:
Subsequent Treatment
of Client:
(NEEDING MEDICAL TREATMENT)
To be completed in all cases of accidents requiring medical attention or where there is concern.
Complete electronically and forward to the Manager within 24 hours.
Full Name of Client:
Date of Birth:
Parent’s/Guardian
Name:
Address Postcode:
Telephone:
Date and Time of
Accident:
Where accident
occurred:
Description of How
Accident Occurred:
First aid given:
First Aid Administered
by:
Nature of Injury:
Was Medical Attention Yes By Whom?:
Recommended? No
YES/NO
Was Medical Attention Yes By Whom?:
Secured? YES/NO No
Name of Medical
Centre/Hospital:
Name of Doctor:
Subsequent Treatment
of Client:
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Sketch of area where
accident occurred:
Sketch is to include the
following details (locate
1-5 on sketch):
1) Position where
accident
occurred.
2) Position of
nearest
Supervisor.
3) Position of
remainder
of group.
4) Approximately
distance from
accident to
Supervisor.
5) Any other
relevant details.
Director of service: Date:
Risk Assessment and follow up (Risk Control Plan):
If a child receives medical treatment, ACECQA needs to be notified within 24 hours and a Children’s
Services Liaison Officer is to be notified, so an independent accident investigation can be conducted.
Printable Version: Form C
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 9
accident occurred:
Sketch is to include the
following details (locate
1-5 on sketch):
1) Position where
accident
occurred.
2) Position of
nearest
Supervisor.
3) Position of
remainder
of group.
4) Approximately
distance from
accident to
Supervisor.
5) Any other
relevant details.
Director of service: Date:
Risk Assessment and follow up (Risk Control Plan):
If a child receives medical treatment, ACECQA needs to be notified within 24 hours and a Children’s
Services Liaison Officer is to be notified, so an independent accident investigation can be conducted.
Printable Version: Form C
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 9
FORM D: ACCIDENT AT HOME – RECORD OF INJURY NOT
OCCURRING IN CARE
Child’s Name:
Date of Birth:
Date Injury/Behaviour Conversation with Name of Staff
Parent
Printable Version: From D
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 10
OCCURRING IN CARE
Child’s Name:
Date of Birth:
Date Injury/Behaviour Conversation with Name of Staff
Parent
Printable Version: From D
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 10
FORM E: PROFESSIONAL INDEMNITY NOTIFICATION
(Please keep this form in the child’s file)
Date Sparkling Stars Childcare Centre was first aware of the
circumstances, which may result in a claim being made:
Particulars of Incident
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
Location
…………………………………………………………………………………………………………………….
Third Party name
…………………………………………………………………………………………………………………..
Particulars of Involvement of Professional Staff
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 11
(Please keep this form in the child’s file)
Date Sparkling Stars Childcare Centre was first aware of the
circumstances, which may result in a claim being made:
Particulars of Incident
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
Location
…………………………………………………………………………………………………………………….
Third Party name
…………………………………………………………………………………………………………………..
Particulars of Involvement of Professional Staff
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
Accident, Incident, Trauma
Policy © Compliant Learning
Resources
Version No.1.0 Produced 17 December
2014 Page 11
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INJURY/ INCIDENT LETTER
Your child (full name) __________________ has been sent home on ______________________
From (Centre) ……………………………………….. due to the following:
Injury or incident details: _________________________________________________________
______________________________________________________________________________
Details of First Aid administered:____________________________________________________
First Aid administered by:__________________________________________________________
The last time your child ate and drank at the centre : _______ am / pm
Your child ate and drank the following: _______________________________________________
Other Comments: _______________________________________________________________
Did the child display any abnormal behaviour after the accident? YES/NO
Has the child blacked out or vomited since the injury?: YES/NO
If Yes, details: __________________________________________________________________
______________________________________________________________________________
Any other Injury/incident management notes:
______________________________________________________________________________
______________________________________________________________________________
Procedure for child being collected:
Educator Name who contacted parent __________________________
Called parent / emergency contact at _______ am / pm
Parent / emergency contact arrived at _______ am / pm
Is medical attention recommended? YES/NO
Was ambulance required? YES/NO
Please Note: The service will take all reasonable care, however, in the event of a child suffering an accident
or illness, the service will not be responsible for the costs of any medical attention or treatment administered to
a child, nor will the service be responsible directly or indirectly for any act or omission of any medical or dental
practitioner or medical officer attending or treating a child
Educator/Centre Director Signature of person Relationship
Signature collecting ill child
Printable Version: FORM E
Accident, Incident, Trauma
Policy Version No.1.0 Produced 17 December 2014
© Compliant Learning Resources
Page
12
Your child (full name) __________________ has been sent home on ______________________
From (Centre) ……………………………………….. due to the following:
Injury or incident details: _________________________________________________________
______________________________________________________________________________
Details of First Aid administered:____________________________________________________
First Aid administered by:__________________________________________________________
The last time your child ate and drank at the centre : _______ am / pm
Your child ate and drank the following: _______________________________________________
Other Comments: _______________________________________________________________
Did the child display any abnormal behaviour after the accident? YES/NO
Has the child blacked out or vomited since the injury?: YES/NO
If Yes, details: __________________________________________________________________
______________________________________________________________________________
Any other Injury/incident management notes:
______________________________________________________________________________
______________________________________________________________________________
Procedure for child being collected:
Educator Name who contacted parent __________________________
Called parent / emergency contact at _______ am / pm
Parent / emergency contact arrived at _______ am / pm
Is medical attention recommended? YES/NO
Was ambulance required? YES/NO
Please Note: The service will take all reasonable care, however, in the event of a child suffering an accident
or illness, the service will not be responsible for the costs of any medical attention or treatment administered to
a child, nor will the service be responsible directly or indirectly for any act or omission of any medical or dental
practitioner or medical officer attending or treating a child
Educator/Centre Director Signature of person Relationship
Signature collecting ill child
Printable Version: FORM E
Accident, Incident, Trauma
Policy Version No.1.0 Produced 17 December 2014
© Compliant Learning Resources
Page
12
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