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All information about incidents and accidents should be recorded on the attached Incident/ Accident report form:
Date and time of the incident
Date:
Time.........................................
Weather conditions.............................................................................................................................
Location of incident.............................................................................................................................
Description of incident.........................................................................................................................
................................................................................................................................................................
................................................................................................................................................................
Equipment/area involved......................................................................................................................
................................................................................................................................................................
Contributing factors if known................................................................................................................
................................................................................................................................................................
If the incident involved injury the following information should also be recorded in writing:
Child/Educator/parents details
Last Name.........................................................First Name....................................................................
Details of the injury sustained...............................................................................................................
...............................................................................................................................................................
Person/s notified - time and date of notification
Parent/ Nominated Educator........................................................ Date:
Director/Principal/Coordinator.............................................. Date:
Time.....................
Time.....................
Initial treatment...................................................................................................................................
................................................................................................................................................................
................................................................................................................................................................
Subsequent treatment (if known).........................................................................................................
................................................................................................................................................................
Corrective action/repair/maintenance recommended........................................................................
...............................................................................................................................................................
Date corrective action completed:
Director/Principal/Coordinator: