Get Doh Incident Report

Filling out the Doh Incident Report is essential for documenting incidents related to residents in adult care facilities. This guide will provide you with clear, step-by-step instructions on how to complete the report accurately and efficiently.

Follow the steps to complete the Doh Incident Report

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin by entering the facility name and the county where the incident occurred. This information is crucial for identifying the location of the incident.
3. Next, specify the date and time of the incident. Accurate timestamps help in tracking the timeline of events.
4. Indicate the regulations applicable to the incident by selecting the relevant options provided in the form.
5. Complete the section for the resident's name and mark all applicable levels of care. This ensures the proper categorization of the resident's needs.
6. In the reportable incidents section, check all incidents that apply, such as unknown whereabouts, injuries, or attempts of self-harm. If applicable, fill out the addendum for a resident's death or suicide attempt.
7. Provide a detailed incident description, including injuries and first aid provided, along with a record of employee involvement.
8. Document the immediate actions taken in response to the incident, such as medical treatments or further care provided.
9. In the Quality Assurance review section, describe the actions taken based on the review of this incident.
10. List individuals or agencies that provided care and specify the location where care was given.
11. Outline the current status of the resident(s) involved in the incident, providing any updates if available.
12. Collect the administrator or operator's signature and date, confirming that the report is completed.
13. If the resident wishes to include their own description of the incident, provide the space for their comments, or check the option if they do not wish to comment.
14. Fill out the reporting section, indicating who is reporting the incident and any relevant dates for notifications to authorities, such as the Department of Health or law enforcement.
15. After completing the report, review all entries for accuracy. Save changes, and download or print the report for your records or submission.

Complete your Doh Incident Report online to ensure compliance and maintain accurate records.