Get Fl Early Learning Coalition Sr-61f-19 - Pinellas County 2020-2025

Filling out the FL Early Learning Coalition SR-61F-19 form is essential for reporting any unusual incidents involving the safety and health of children. This guide will provide you with clear, step-by-step instructions to ensure accurate completion of the form.

Follow the steps to complete the FL Early Learning Coalition SR-61F-19 form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter today's date in the designated field to indicate when the report is being completed.
3. Select the type of incident you are reporting by checking the appropriate box for 'Accident' or 'Incident'.
4. Fill in the date and time of the accident or incident using the provided spaces.
5. Provide the name of the provider or center, along with your contact information including phone number and address.
6. Indicate who has completed the report along with their title.
7. List the first and last names of all participants involved or witnesses to the incident, including their age and sex.
8. Describe the incident in detail in the space provided, ensuring to write in complete sentences.
9. Answer whether medical services were required; if yes, describe the treatment and outcome.
10. State whether the incident was handled appropriately; if no, explain how it could have been managed better.
11. If applicable, indicate if the Child Abuse Hotline was notified, and provide the name of the Registry Counselor if applicable.
12. Respond to questions regarding legal actions or notifications to Pinellas County Child Care Licensing and the parent or guardian.
13. Assess whether changes in procedures are necessary to prevent future occurrences, and provide details if changes are proposed.
14. Ensure all fields have been addressed, and save your changes.
15. Download, print, or share the completed form as necessary. Ensure it is uploaded to the Provider Portal Document Library Unusual Incidents Folder and email a copy to the Early Learning Coalition.

Start filling out your FL Early Learning Coalition SR-61F-19 form online today to ensure compliance and safety!